Angeline Hadiwidjaja, MD
NPI 1417049792 · Pediatrics Physician · Fremont, CA
Enrolled with Medicare as Practitioner - Pediatric Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Angeline Hadiwidjaja, MD is a Pediatrics Physician provider in Fremont, CA (NPI 1417049792).
Provider details
- NPI number
- 1417049792
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- A67186 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-09-28
- Last updated
- 2020-05-14
- Certified
- 2020-05-14
Frequently asked questions
- What is Angeline Hadiwidjaja's NPI number?
- Angeline Hadiwidjaja's National Provider Identifier (NPI) is 1417049792, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Angeline Hadiwidjaja's specialty?
- Angeline Hadiwidjaja is listed in the NPPES registry with a primary specialty of Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Angeline Hadiwidjaja located?
- Angeline Hadiwidjaja's practice location on file with NPPES is 3200 Kearney St, Fremont, CA 94538-2299.
- What is Angeline Hadiwidjaja's phone number?
- The practice phone number listed in the NPPES registry for Angeline Hadiwidjaja is (510) 490-1222.
- Does Angeline Hadiwidjaja accept Medicare?
- Angeline Hadiwidjaja is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Angeline Hadiwidjaja's NPI active?
- Yes — Angeline Hadiwidjaja's NPI (1417049792) is active in the NPPES registry as of the last update on 2020-05-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.