Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jani Widjaja, MD

Individual provider Diagnostic Radiology Physician · NPI 1902881287

Dr. Jani Widjaja, MD is a Diagnostic Radiology in Lawrenceville, Georgia. Graduated from University of Texas Medical Branch at Galveston in 1991, 35 years ago. Practices with North Metropolitan Radiology Associates LLP, a 45-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
35
Trained at
University of Texas Medical Branch at Galveston
Licensed in
GA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1000 Medical Center Blvd Radiology Dept
Lawrenceville, GA 30045-7694
Phone: (770) 995-4321
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 49221 (GA)

Record details

NPI number1902881287
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 9, 2005
Last updated in NPPESApril 6, 2022
Certification dateApril 6, 2022
Mailing addressPo Box 1746, Indianapolis, IN 46206-1746

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolUNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduated 1991 (35 years in practice)
Group practice North Metropolitan Radiology Associates Llp — 45 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

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