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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JASEN TJAHJADI
NPI 1649839077
Family Medicine in Brentwood, CA

Active since June 10, 2019PECOS Enrolled
171 SAND CREEK RD STE A, BRENTWOOD, CA 94513(717) 544-4940 Get Directions Write a Review

NPPES record last updated: June 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jasen Tjahjadi NPPES

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

JASEN TJAHJADI (NPI 1649839077) is an individual family medicine provider in Brentwood, California, licensed in California (A176433) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS and is a graduate of Eastern Virginia Medical School (2019).

NPPES Registry Identity

NPI1649839077
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJASEN TJAHJADI
Location Address171 SAND CREEK RD STE ABrentwood, CA 94513-2057
Mailing Address171 Sand Creek Rd Ste ABrentwood, CA 94513-2057
Phone(717) 544-4940
Sole ProprietorNo
Medical School CMSEastern Virginia Medical SchoolGraduated 2019
Enumeration DateJune 10, 2019
Last NPPES UpdateJune 18, 2026
NPPES CertifiedJune 18, 2026
✔ NPI 1649839077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A176433
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License MT217899 (PA)
171 SAND CREEK RD STE A, Brentwood, CA 94513
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jasen Tjahjadi is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9830424548
PECOS Enrollment IDI20260317003387
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94513 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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

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

MS. CATHERINE ANNE BERG NP, FNP-BC, ACNP-BC
Nurse Practitioner (Family)
171 SAND CREEK RD STE A
BRENTWOOD, CA 94513
Contra Costa County (800) 495-8885

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 Jasen Tjahjadi's NPI number?

The NPI number for Jasen Tjahjadi is 1649839077. It was assigned to this individual provider in the NPPES registry on June 10, 2019.

Where is Jasen Tjahjadi located?

Jasen Tjahjadi practices at 171 Sand Creek Rd Ste A, Brentwood, CA 94513. The listed phone number is (717) 544-4940.

What is Jasen Tjahjadi's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jasen Tjahjadi enrolled in Medicare?

Yes. Jasen Tjahjadi is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jasen Tjahjadi was last updated on June 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 52 days 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.