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

Haggan Julijanto

Individual provider Physician Assistant · NPI 1871460055

Haggan Julijanto is a Physician Assistant in Kokomo, Indiana. Qualified in 2025, 1 year ago. Practices with Urgentchoice Care LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
1
Licensed in
IN
In the registry since
2025
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2004 W Sycamore St
Kokomo, IN 46901-4112
Phone: (574) 780-0102
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10005054A (IN)

Record details

NPI number1871460055
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedOctober 21, 2025
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Urgentchoice Care Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Kokomo