Jabez Gondokusumo, MD
NPI 1700637162 · Student in an Organized Health Care Education/Training Program · Durham, NC
Enrolled with Medicare as Order and Referring Only - Urology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jabez Gondokusumo, MD is a Student in an Organized Health Care Education/Training Program provider in Durham, NC (NPI 1700637162).
Provider details
- NPI number
- 1700637162
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
83% 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
- 2024-04-01
- Last updated
- 2024-04-01
- Certified
- 2024-04-01
Frequently asked questions
- What is Jabez Gondokusumo's NPI number?
- Jabez Gondokusumo's National Provider Identifier (NPI) is 1700637162, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jabez Gondokusumo's specialty?
- Jabez Gondokusumo is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).
- Where is Jabez Gondokusumo located?
- Jabez Gondokusumo's practice location on file with NPPES is 2301 Erwin Rd, Durham, NC 27705-4699.
- What is Jabez Gondokusumo's phone number?
- The practice phone number listed in the NPPES registry for Jabez Gondokusumo is (919) 684-8111.
- Does Jabez Gondokusumo accept Medicare?
- Jabez Gondokusumo is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jabez Gondokusumo's NPI active?
- Yes — Jabez Gondokusumo's NPI (1700637162) is active in the NPPES registry as of the last update on 2024-04-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.