Shirley Prasetyo Buntoro, DO
NPI 1831727239ActiveIndividual· Family Medicine· Sayre, PA
Family Medicine (DO) with Christus Trinity Clinic Texas, practicing in Sayre, Pennsylvania. Their prescriptions cost Medicare Part D more than their services did: $70,601 for 1,020 claims, against $17,238 paid for services in 2024. Novo Nordisk Inc reported $34.47 in payments in 2024, mostly food and beverage. Lists Christus Mother Frances Hospital as a hospital affiliation.
Overview
| NPI | 1831727239 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DO |
| Sole proprietor | Yes |
| NPI issued | Mar 31, 2020 |
| Last updated in NPPES | Jul 19, 2023 |
| Certified by provider | Jul 19, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | U4752 | TX |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Family Practice (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 123 |
|---|---|
| Services billed | 322 across 19 procedure codes |
| Paid by Medicare | $17,238 |
Part D prescriptions in 2024
| Prescriptions (claims) | 1,020 · 2,021 30-day fills |
|---|---|
| Patients | 192 |
| Total drug cost | $70,601 |
| Generic share | 87% of claims |
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Family Practice |
| Telehealth | Offers telehealth |
Medical group
- Christus Trinity Clinic TexasTyler, TX · 1,540 clinicians
Hospital affiliation
- Christus Mother Frances HospitalTyler, TX
Other facilities
- Christus HomecareHome health agency · Tyler, TX
Industry payments (Open Payments)
- 2024$34.47 · 2 payments from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Novo Nordisk Inc | $34.47 | 2 |
What the 2024 payments were for
- Food and Beverage$34.47 · 2 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 31 family medicine physicians in Sayre · All family medicine physicians in Pennsylvania