DR. ELYSA WIDJAJA MD
NPI 1184331522
Radiology - Pediatric Radiology in Cincinnati, OH
NPI Status: Active since November 04, 2022
Contact Information
3333 BURNET AVE
ML 5031
CINCINNATI, OH
ZIP 45229
Phone: (513) 636-4251
Fax: (513) 636-8145
- Individual
- Female
- Radiology
- Pediatric Radiology
- PECOS Enrolled
About ELYSA WIDJAJA
This page provides the complete NPI Profile along with additional information for Elysa Widjaja, a provider established in Cincinnati, Ohio with a medical specialization in Radiology, focusing in pediatric radiology . The healthcare provider is registered in the NPI registry with number 1184331522 assigned on November 2022. The practitioner's primary taxonomy code is 2085P0229X with license number 35.155182 (OH). The provider is registered as an individual and her NPI record was last updated February 2026.
- NPI
- 1184331522
- Provider Name
- DR. ELYSA WIDJAJA MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 3333 BURNET AVE ML 5031 CINCINNATI, OH 45229
- Location Phone
- (513) 636-4251
- Location Fax
- (513) 636-8145
- Mailing Address
- 3333 BURNET AVE ML 5031 CINCINNATI, OH 45229
- Mailing Phone
- (513) 636-4251
- Mailing Fax
- (513) 636-8145
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-04-2022
- Last Update Date
- 02-12-2026
- Code Navigator
Location Map
Secondary Locations
- Lurie Children's Hospital 225 E. Chicago Avenue
Chicago, IL 60611
(312) 227-3475 - 676 N Saint Clair St Ste 800
Chicago, IL 60611
(312) 695-5753
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Radiology Pediatric Radiology
- Taxonomy Code
- 2085P0229X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 35.155182
- License State
- OH
- Taxonomy Description
- A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2085P0229X | Allopathic & Osteopathic Physicians | Radiology | 036.161747 (IL) |
| 2 | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | 036161747 (IL) |
Medicare Participation & PECOS Enrollment Status
Elysa Widjaja is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1184331522, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
CINCINNATI, OH 45229
CINCINNATI, OH 45229
CINCINNATI, OH 45229
CINCINNATI, OH 45229
CINCINNATI, OH 45229
CINCINNATI, OH 45229
CINCINNATI, OH 45229
CINCINNATI, OH 45229
CINCINNATI, OH 45229
CINCINNATI, OH 45229
CINCINNATI, OH 45229
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1184331522, enumerated as an "individual" on November 04, 2022.
The provider is located at 3333 BURNET AVE ML 5031 CINCINNATI, OH 45229 and the phone number is (513) 636-4251.
Radiology with taxonomy code 2085P0229X and a focus in Pediatric Radiology.
