Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Budiarto Ranoewidjojo, DO

Individual provider Emergency Medicine Physician · NPI 1417187352

Dr. Budiarto Ranoewidjojo, DO is an Emergency Medicine in New York, New York. Qualified in 2005, 21 years ago. Practices with City Medical of Upper East Side PLLC, a 663-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
21
Licensed in
NY
In the registry since
2009
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

506 Lenox Ave
New York, NY 10037-1802
Phone: (212) 939-2251
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 253948 (NY)

Record details

NPI number1417187352
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedJuly 24, 2009
Last updated in NPPESJuly 24, 2009

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice City Medical Of Upper East Side Pllc — 663 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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