DR. CHRISTOPHER F TENGGARDJAJA (M.D.) – Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician, NPI 1003029646

DR. CHRISTOPHER F TENGGARDJAJA (M.D.) is a healthcare provider. based in Cleveland, Ohio. specializing in UROLOGY. They hold the professional credentials M.D.. They hold a License No. A100721 (CA). The NPI Number for DR. CHRISTOPHER F TENGGARDJAJA (M.D.) is 1003029646

Main info

Male
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHRISTOPHER F TENGGARDJAJA (M.D.)
NPI
1003029646
Phone
Not provided
Address
9500 EUCLID AVE
Enumeration Date
8 May 2007
Last Update Date
4 November 2021

Doctor Profile

Medical School Name
NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Secondary Phone
3237834011
Graduation Year
2006 (20 years ago)
PAC ID
6305096389
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20141108000360
Address ID
CA900275814LO4900XBLVD400
Telehealth
Yes

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

568 UROLOGY in OH

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Provider Addresses for DR. CHRISTOPHER F TENGGARDJAJA (M.D.)

  • Cleveland Clinic, 9500, Euclid Avenue, Newton Avenue Historic District, University Circle, Cleveland, Cuyahoga County, Ohio, 44195, United States

    Q10-1

    CLEVELAND, OH 441950001

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $312.

Total Amount is formed as General ($312) + Research ($0) + Ownership ($0) = $312.

Last reported payment date: 2024-10-29 • Largest payer in this snapshot: Medtronic, Inc. ($162).

Total Amount

$312

General + Research + Ownership

Payments

5

Total payment records

General Amount

$312

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-29

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Medtronic, Inc.$162
Axonics, Inc.$149
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-11-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141108000360IUrologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44195)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

What is the registry number for DR. CHRISTOPHER F TENGGARDJAJA (M.D.)?
The registry entry for DR. CHRISTOPHER F TENGGARDJAJA (M.D.) shows NPI 1003029646.
Does the public listing show DR. CHRISTOPHER F TENGGARDJAJA (M.D.) as active?
DR. CHRISTOPHER F TENGGARDJAJA (M.D.)'s NPI record reflects an active status in NPPES.
What does the directory say DR. CHRISTOPHER F TENGGARDJAJA (M.D.) does?
Insurance directories may phrase it differently, but here DR. CHRISTOPHER F TENGGARDJAJA (M.D.) maps to Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician. Clinical services aligned with this taxonomy classification.
Is DR. CHRISTOPHER F TENGGARDJAJA (M.D.) tied to Cleveland, Ohio?
If you are local to Cleveland, Ohio, DR. CHRISTOPHER F TENGGARDJAJA (M.D.) may be relevant to your search.
Who maintains DR. CHRISTOPHER F TENGGARDJAJA (M.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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