1. Home
  2. Directory
  3. District Of Columbia
  4. Washington
  5. Internal Medicine
  6. NPI Profile

MOMODU A JACK M.D.
NPI 1164521019
Internal Medicine - Gastroenterology in Washington, DC

Active since September 21, 2006PECOS EnrolledAccepts Medicare Assignment
2139 GEORGIA AVE NW, SUITE 3A, WASHINGTON, DC 20001(202) 865-7981(301) 621-5313 Get Directions Write a Review

NPPES record last updated: November 6, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Momodu A Jack M.d. NPPES

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

MOMODU A JACK M.D. (NPI 1164521019) is an individual gastroenterology provider in Washington, District Of Columbia, licensed in District Of Columbia (MD20286) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Culpeper, and is a graduate of Other (1985).

NPPES Registry Identity

NPI1164521019
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameMOMODU A JACKCredential: M.D.
Location Address2139 GEORGIA AVE NW, SUITE 3AWashington, DC 20001-3035
Mailing AddressPo Box 2325Columbia, MD 21045-1325 · (202) 865-7981 · Fax (301) 621-5313
Phone(202) 865-7981
Fax(301) 621-5313
Sole ProprietorYes
Medical School CMSOtherGraduated 1985
Enumeration DateSeptember 21, 2006
Last NPPES UpdateNovember 6, 2020
NPPES CertifiedNovember 6, 2020
✔ NPI 1164521019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses✔ Licensed in DC · MD20286✔ Licensed in VA · 0101270422✔ Licensed in MD · D0044035
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
2139 GEORGIA AVE NW, Washington, DC 20001
Open in Google Maps ↗

Secondary Practice Location 1

Location 1541 Sunset Ln Ste 301Culpeper, VA 22701-3979 · Phone (540) 825-4557 · Fax (540) 825-4566

Other Identifiers 3

Other0101267872VA · License
Medicaid018868500DC
Medicaid174961700MD

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Momodu A Jack M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981899648
PECOS Enrollment IDI20101109000138
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.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
37 services29 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
32 services32 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
26 services26 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
22 services22 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
17 services17 patients
Diagnostic exam of large bowel using a flexible endoscope 45378
This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.
17 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20001 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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 13

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

DR. RUFINA NWANNEKA ODIGWE M.D
Family Medicine
2139 GEORGIA AVE NW, SUITE 3B
WASHINGTON, DC 20001
District of Columbia (202) 865-1452
DR. BABATUNDE OLUFEMI ARANMOLATE M.D
General Acute Care Hospital
2139 GEORGIA AVE NW
WASHINGTON, DC 20001
District of Columbia (202) 865-3250
NOEL MANYINDO M.D., MBA
Family Medicine
2139 GEORGIA AVE NW, SUITE 3-B
WASHINGTON, DC 20001
District of Columbia (202) 865-3250
SABRINA KHAN HARRELL MD
Student in an Organized Health Care Education/Training Program
2139 GEORGIA AVE NW
WASHINGTON, DC 20001
District of Columbia (202) 865-1432
BABAFEMI B ADENUGA MD
Family Medicine
2139 GEORGIA AVE NW, 4TH FLOOR
WASHINGTON, DC 20001
District of Columbia (202) 865-7499
DR. ADEOLA OPEYEMI ADEYEYE MD
Family Medicine
2139 GEORGIA AVE NW, HOWARD UNIVERSITY HOSPITAL FAMILY HEALTH CENTER
WASHINGTON, DC 20001
District of Columbia (202) 865-3250
OLUWATOYIN TOLANI FALEBITA M.D
Clinic/Center (Primary Care)
2139 GEORGIA AVE NW
WASHINGTON DC, DC 20001
District of Columbia (202) 865-1452
DR. NGOZI P. EGU M.D.
Student in an Organized Health Care Education/Training Program
2139 GEORGIA AVE NW, SUITE #3B
WASHINGTON, DC 20001
District of Columbia (202) 865-1452

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 Momodu Jack's NPI number?

The NPI number for Momodu Jack is 1164521019. It was assigned to this individual provider in the NPPES registry on September 21, 2006.

Where is Momodu Jack located?

Momodu Jack practices at 2139 Georgia Ave NW Suite 3A, Washington, DC 20001. The listed phone number is (202) 865-7981.

What is Momodu Jack's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Momodu Jack enrolled in Medicare?

Yes. Momodu Jack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Momodu Jack was last updated on November 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.