DAVID WIDJAJA MD
NPI 1194985291
Internal Medicine - Gastroenterology in Bronx, NY
About David Widjaja Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVID WIDJAJA MD (NPI 1194985291) is an individual gastroenterology provider in Bronx, New York, licensed in New York (275018) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Albany Medical Center Hospital, and is a graduate of Other (1996).
NPPES Registry Identity
Specialties & Licenses 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
David Widjaja Md 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.
Medicare Billing Reassignments
2Medicare enrollment records show David Widjaja reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Albany, NY 12208
- Reassigned Medicare billing, New York enrollment
- 1,640 clinicians in this Medicare group
Wahpeton, ND 58075
- Reassigned Medicare billing, North Dakota enrollment
- 617 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Albany Medical Center Hospital
Acute Care Hospitals · Albany, NYEssentia Health
Acute Care Hospitals · Fargo, NDPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10457 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BRONX, NY 10457
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 David Widjaja's NPI number?
The NPI number for David Widjaja is 1194985291. It was assigned to this individual provider in the NPPES registry on June 11, 2008.
Where is David Widjaja located?
David Widjaja practices at 1650 Grand Concourse, Bronx, NY 10457. The listed phone number is (718) 960-1234.
What is David Widjaja's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.
Is David Widjaja enrolled in Medicare?
Yes. David Widjaja 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.
Which organizations bill Medicare for David Widjaja's services?
According to the CMS Revalidation Reassignment List (October 2026 release), David Widjaja reassigns Medicare benefits to 2 organizations: Albany Medical College (Albany, NY) and Innovis Health, LLC. (Wahpeton, ND). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for David Widjaja's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does David Widjaja accept?
Health plans from Blue Cross Blue Shield of North Dakota and Sanford Health Plan list David Widjaja as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is David Widjaja affiliated with any hospitals?
According to CMS data, David Widjaja is affiliated with Albany Medical Center Hospital and Essentia Health.
When was this NPI record last updated?
The NPPES record for David Widjaja was last updated on May 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# David Widjaja, MD · NPI 1194985291
Gastroenterology physician in Bronx, New York. Individual provider, active in the CMS NPPES registry since June 11, 2008.
## Identity
- **NPI:** 1194985291 (Entity type: Individual)
- **Enumerated:** June 11, 2008
- **Primary specialty:** Internal Medicine - Gastroenterology · taxonomy 207RG0100X
- **State license:** 275018 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1650 GRAND CONCOURSE, Bronx, NY 10457-7606
- **Phone:** (718) 960-1234
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Albany Medical College (NPI 1497921688, Albany, NY); Innovis Health, LLC. (NPI 1790965440, Wahpeton, ND) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1996
## Record status
- **NPPES last updated:** May 14, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1194985291) · Data from the CMS NPPES public registry.