Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nerisa Iolani Soeharto, PA-C

Individual provider Physician Assistant · NPI 1770360588

Nerisa Iolani Soeharto, PA-C is a Physician Assistant in Austin, Texas. Qualified in 2023, 3 years ago. Practices with Doctx3 PLLC, a 83-clinician group, works from 3 locations and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3110 Guadalupe St Ste 100
Austin, TX 78705-2858
Phone: (512) 675-1359
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 709 E Slaughter Ln Ste 404, Austin, TX 78744-2156 — (512) 277-6643
  • 2000 S I-35 Frontage Rd Suite N-5, Round Rock, TX 78681 — (512) 729-3138

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1770360588
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 14, 2023
Last updated in NPPESApril 9, 2024
Certification dateApril 9, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Doctx3 Pllc — 83 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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