JOANNA WENAS WIDJAJA DC
NPI 1639909682
Chiropractor in Sergeant Bluff, IA
About Joanna Wenas Widjaja Dc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOANNA WENAS WIDJAJA DC (NPI 1639909682) is an individual chiropractor in Sergeant Bluff, Iowa, licensed in Iowa (125921) and active in the NPI registry since August 2024. She is a graduate of Northwestern College Of Chiropractic (2023).
NPPES Registry Identity
Specialties & Licenses
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
Joanna Wenas Widjaja Dc 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 Reassignment
Medicare enrollment records show Joanna Widjaja reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Sergeant Bluff, IA 51054
- Reassigned Medicare billing, Iowa enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Joanna Widjaja's NPI number?
The NPI number for Joanna Widjaja is 1639909682. It was assigned to this individual provider in the NPPES registry on August 5, 2024.
Where is Joanna Widjaja located?
Joanna Widjaja practices at 204 1st St Ste 111, Sergeant Bluff, IA 51054. The listed phone number is (712) 301-7537.
What is Joanna Widjaja's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Joanna Widjaja enrolled in Medicare?
Yes. Joanna 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 organization bills Medicare for Joanna Widjaja's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Joanna Widjaja reassigns Medicare benefits to Jiwa Chiropractic & Wellness (Sergeant Bluff, IA). The 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 Joanna Widjaja's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Joanna Widjaja was last updated on September 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Joanna Wenas Widjaja, DC · NPI 1639909682
Chiropractor provider in Sergeant Bluff, Iowa. Individual provider, active in the CMS NPPES registry since August 5, 2024.
## Identity
- **NPI:** 1639909682 (Entity type: Individual)
- **Enumerated:** August 5, 2024
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **State license:** 125921 (Iowa)
- **Sole proprietor:** No
## Practice location
- **Address:** 204 1ST ST STE 111, Sergeant Bluff, IA 51054-8532
- **Phone:** (712) 301-7537
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Jiwa Chiropractic & Wellness (NPI 1699596114, Sergeant Bluff, IA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Northwestern College Of Chiropractic, class of 2023
## Record status
- **NPPES last updated:** September 20, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1639909682) · Data from the CMS NPPES public registry.