DAVID WIDJAJA MD
NPI 1194985291
Internal Medicine - Gastroenterology in Bronx, NY

Active since June 11, 2008PECOS EnrolledAccepts Medicare Assignment
1650 GRAND CONCOURSE, BRONX, NY 10457(718) 960-1234 Get Directions Write a Review

NPPES record last updated: May 14, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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

NPI1194985291
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDAVID WIDJAJACredential: MD
Location Address1650 GRAND CONCOURSEBronx, NY 10457-7606
Mailing Address1650 Selwyn Ave, 10th FloorBronx, NY 10457-7626 · (718) 960-1234
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateJune 11, 2008
Last NPPES UpdateMay 14, 2014
NPI 1194985291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License Licensed in NY · 275018
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.
Also ListedInternal MedicineTaxonomy 207R00000X · License 275018 (NY)
Also ListedInternal Medicine · Geriatric MedicineTaxonomy 207RG0300X · License 275018 (NY)
1650 GRAND CONCOURSE, Bronx, NY 10457

Accepted Insurance

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

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.

PECOS PAC ID7315013703
PECOS Enrollment IDI20080909000378, I20180920002035
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 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.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
31 services31 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.
22 services22 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.
12 services12 patients

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, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330013
Location43 New Scotland Avenue, Mail Code 34Albany, NY 12208 · Albany County
Emergency services Birthing friendly

Essentia Health

Acute Care Hospitals · Fargo, ND
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number350070
Location3000 32nd Ave SouthFargo, ND 58104 · Cass County
Emergency services Birthing friendly

Physician 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.

New Patient
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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 20

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

Speech-Language Pathologist
1650 GRAND CONCOURSE
BRONX, NY 10457
Clinic/Center
1650 GRAND CONCOURSE
BRONX, NY 10457
Emergency Medicine
1650 GRAND CONCOURSE
BRONX, NY 10457
Family Medicine
1650 GRAND CONCOURSE
BRONX, NY 10457
Student in an Organized Health Care Education/Training Program
1650 GRAND CONCOURSE
BRONX, NY 10457
Internal Medicine (Gastroenterology)
1650 GRAND CONCOURSE
BRONX, NY 10457
Internal Medicine
1650 GRAND CONCOURSE
BRONX, NY 10457
Family Medicine
1650 GRAND CONCOURSE
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.

What insurance does David Widjaja accept?

Health plans from Blue Cross Blue Shield of North Dakota, Medica 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.