Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Jennifer Widjaja

Individual provider Gerontology Nurse Practitioner · NPI 1942008651

Jennifer Widjaja is a Nurse Practitioner in Mesa, Arizona. Qualified in 2023, 3 years ago. Practices with Leading Healthcare PLLC, a 46-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
3
Licensed in
AZ
In the registry since
2025
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Practice location Address checks out

8035 E Brown Rd
Mesa, AZ 85207-3901
Phone: (623) 295-1190
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 317968 (AZ)

Record details

NPI number1942008651
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 6, 2025
Last updated in NPPESMarch 6, 2025
Certification dateMarch 6, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Leading Healthcare Pllc — 46 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Leading Healthcare PLLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 46 clinicians in the practice; 12 are shown here.

Other providers in Mesa