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

Mr. Indra Soerja Oetomo, PT, LAC

Individual provider Acupuncturist · NPI 1326005745

Mr. Indra Soerja Oetomo, PT, LAC is a Physical Therapist in Private Practice in Highlands Ranch, Colorado. Qualified in 1984, 42 years ago. Accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
42
Licensed in
CO
In the registry since
2006
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
LAC — Licensed Associate Counselor
A counsellor practising under supervision toward full licensure. In some states the same letters mean Licensed Acupuncturist.

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Practice location Address checks out

8955 S Ridgeline Blvd Ste 400
Highlands Ranch, CO 80129-2362
Phone: (303) 683-8338
Fax: (303) 683-8809
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acupuncturist (primary) Taxonomy 171100000X · Licence 978 (CO)
Orthopedic Physical Therapist Taxonomy 2251X0800X · Licence 3579 (CO)

Record details

NPI number1326005745
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , LAC
Sole proprietorNo
NPI enumeratedApril 28, 2006
Last updated in NPPESSeptember 11, 2025

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1984 (42 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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