JENNIFER WIDJAJA
NPI 1942008651
Nurse Practitioner - Gerontology in Mesa, AZ
About Jennifer Widjaja NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JENNIFER WIDJAJA (NPI 1942008651) is an individual gerontology provider in Mesa, Arizona, licensed in Arizona (317968) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
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
Jennifer Widjaja 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
4Medicare enrollment records show Jennifer Widjaja reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Phoenix, AZ 85020
- Reassigned Medicare billing, Arizona enrollment
- 13 clinicians in this Medicare group
Phoenix, AZ 85020
- Reassigned Medicare billing, Arizona enrollment
- 28 clinicians in this Medicare group
Sun City, AZ 85351
- Reassigned Medicare billing, Arizona enrollment
- 64 clinicians in this Medicare group
Goodyear, AZ 85395
- Reassigned Medicare billing, Arizona enrollment
- 16 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 85207 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.
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 Jennifer Widjaja's NPI number?
The NPI number for Jennifer Widjaja is 1942008651. It was assigned to this individual provider in the NPPES registry on March 6, 2025.
Where is Jennifer Widjaja located?
Jennifer Widjaja practices at 8035 E Brown Rd, Mesa, AZ 85207. The listed phone number is (623) 295-1190.
What is Jennifer Widjaja's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Jennifer Widjaja enrolled in Medicare?
Yes. Jennifer 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 Jennifer Widjaja's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Widjaja reassigns Medicare benefits to 4 organizations: Maricopa Pulmonary Consultants LLC (Phoenix, AZ), Neurocritical Care And Stroke Of Arizona PLLC (Phoenix, AZ), Leading Healthcare, LLC (Sun City, AZ) and Leading Healthcare Clinic Of Goodyear LLC (Goodyear, AZ). 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 Jennifer Widjaja's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jennifer Widjaja accept?
Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Cigna HealthCare of Arizona, Inc and UnitedHealthcare list Jennifer 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.
When was this NPI record last updated?
The NPPES record for Jennifer Widjaja was last updated on March 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.
# Jennifer Widjaja · NPI 1942008651
Gerontology physician in Mesa, Arizona. Individual provider, active in the CMS NPPES registry since March 6, 2025.
## Identity
- **NPI:** 1942008651 (Entity type: Individual)
- **Enumerated:** March 6, 2025
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 317968 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 8035 E BROWN RD, Mesa, AZ 85207-3901
- **Phone:** (623) 295-1190
## 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:** 4 organizations under Medicare reassignment (form CMS-855R): Maricopa Pulmonary Consultants LLC (NPI 1710413588, Phoenix, AZ); Neurocritical Care And Stroke Of Arizona PLLC (NPI 1649561580, Phoenix, AZ); Leading Healthcare, LLC (NPI 1356853691, Sun City, AZ); Leading Healthcare Clinic Of Goodyear LLC (NPI 1902448566, Goodyear, AZ) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** March 6, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1942008651) · Data from the CMS NPPES public registry.