DR. JAN NEIL WIDERMAN D.O.
NPI 1023197977
Pediatrics in Philadelphia, PA

Q: What is Jan Widerman's NPI number?

The NPI number for Jan Widerman is 1023197977. It was assigned to this individual provider in the NPPES registry on November 3, 2006.

Q: What is Jan Widerman's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Jan Widerman was last updated on February 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 03, 2006PECOS EnrolledCLIA 39D0199504 · Waiver

10800 BUSTLETON AVE, PHILADELPHIA, PA 19116(215) 934-6777(215) 934-6787 Get Directions Write a Review

NPPES record last updated: February 20, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jan Neil Widerman D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAN NEIL WIDERMAN D.O. (NPI 1023197977) is an individual pediatrics provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (OS004029L) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and holds a CLIA Waiver certificate valid through January 24, 2027.

NPPES Registry Identity

NPI1023197977

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. JAN NEIL WIDERMANCredential: D.O.

Location Address10800 BUSTLETON AVEPhiladelphia, PA 19116-3302

Mailing Address10800 Bustleton AvePhiladelphia, PA 19116-3302 · (215) 934-6777 · Fax (215) 934-6787

Phone(215) 934-6777

Fax(215) 934-6787

Sole ProprietorNo

Enumeration DateNovember 3, 2006

Last NPPES UpdateFebruary 20, 2013

✔ NPI 1023197977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in PA · OS004029L

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

10800 BUSTLETON AVE, Philadelphia, PA 19116

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jan Neil Widerman D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D0199504

Jan N Widerman Do, Facop, Faap, PC · Philadelphia, PA

Active · expires Jan 24, 2027

CLIA Number39D0199504

Laboratory TypePhysician Office

Certificate Effective DateJanuary 25, 2025

Certificate Expiration DateJanuary 24, 2027

Laboratory DirectorJan N. Widerman

Laboratory Phone(215) 934-6777

Laboratory LocationJan N Widerman Do, Facop, Faap, PC10800 Bustleton Ave, Philadelphia, PA 19116

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19116 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAN N WIDERMAN P.C.

Clinic/Center (Primary Care)

10800 BUSTLETON AVE
PHILADELPHIA, PA 19116

Philadelphia County (215) 934-6777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jan Widerman's NPI number?

The NPI number for Jan Widerman is 1023197977. It was assigned to this individual provider in the NPPES registry on November 3, 2006.

Where is Jan Widerman located?

Jan Widerman practices at 10800 Bustleton Ave, Philadelphia, PA 19116. The listed phone number is (215) 934-6777.

What is Jan Widerman's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jan Widerman enrolled in Medicare?

Yes. Jan Widerman is registered in the Medicare PECOS enrollment system.

Does Jan Widerman hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D0199504) is associated with this NPI, valid through January 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jan Widerman was last updated on February 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.