Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1184331522 Individual Practitioner Female Practitioner

Dr. Elysa Widjaja , MD

Radiology - Pediatric Radiology • Cincinnati, OH

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Dr. Elysa Widjaja, MD is a registered Radiology - Pediatric Radiology practitioner in Cincinnati, OH. With approximately 31 years of clinical practice since completing medical education in 1995, Dr. Widjaja provides healthcare services at the registered practice location at 3333 BURNET AVE.

Dr. Widjaja does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

3333 Burnet Ave
Ml 5031

Cincinnati, OH 452293026

Telephone 5136364251
Fax 5136368145
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

1995

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Radiology - Pediatric Radiology in Cincinnati, OH

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
31 Yrs +7.2 yrs vs City Avg
City Avg: 23.8 Yrs
State Avg: 21.0 Yrs
Regional Practice Density
53 Specialists

Practicing in Cincinnati, OH (125 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Widjaja (31 Years) 31 Yrs
Cincinnati Specialty Average (23.8 Years) 23.8 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-02-12
Radiology - Pediatric Radiology Primary Specialty

NUCC Taxonomy Code: 2085P0229X

State License OH 35.155182

A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.

Radiology - Pediatric Radiology

NUCC Taxonomy Code: 2085P0229X

State License IL 036.161747

A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.

Radiology - Diagnostic Radiology

NUCC Taxonomy Code: 2085R0202X

State License IL 036161747

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Secondary Practice Locations

Lurie Children's Hospital, 225 E. Chicago Avenue

Chicago, IL 60611

Phone: 3122273475

676 N Saint Clair St Ste 800

Chicago, IL 606112978

Phone: 3126955753

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Preeyacha Pacharn , MD

Radiology - Pediatric Radiology

NPI 1003012964

Doctor of Medicine (M.D.)

Dr. Andrew Schapiro , MD

Radiology - Pediatric Radiology

NPI 1013212869

Doctor of Medicine (M.D.)

Dr. Murat Kocaoglu , MD

Radiology - Pediatric Radiology

NPI 1033695937

Doctor of Medicine (M.D.)

Dr. Betul Derinkuyu , MD

Radiology - Pediatric Radiology

NPI 1033844949

Doctor of Medicine (M.D.)

Dr. Bernadette Koch , MD

Radiology - Pediatric Radiology

NPI 1053324202

Doctor of Medicine (M.D.)

Dr. Brian Coley , MD

Radiology - Diagnostic Radiology

NPI 1083652838

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location February 12, 2026

Registered at 3333 BURNET AVE, ML 5031, CINCINNATI, OH 452293026 (Tel: 5136364251)

📍
Updated Business Mailing Address February 12, 2026

Registered at 3333 BURNET AVE, ML 5031, CINCINNATI, OH 452293026 (Tel: 5136364251)

📍
Updated Business Mailing Address January 26, 2026

Registered at 225 E CHICAGO AVE, CHICAGO, IL 606112991 (Tel: 3122273475)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 26, 2026

Radiology (License #036.161747 in IL)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 06, 2023

Radiology (License #036161747 in IL)

NPI Profile Active November 04, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location November 04, 2022

Registered at LURIE CHILDREN'S HOSPITAL, 225 E. CHICAGO AVENUE, CHICAGO, IL 60611 (Tel: 3122273475)

📍
Updated Business Mailing Address November 04, 2022

Registered at LURIE CHILDREN'S HOSPITAL, 225 E. CHICAGO AVENUE, CHICAGO, IL 60611 (Tel: 3122273475)

👤
Provider Name / Credentials Updated November 04, 2022

Recorded as ELYSA WIDJAJA, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 04, 2022

Radiology (License #036.161747 in IL)

🟢
Initial NPI Registration & Enumeration November 04, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Elysa Widjaja. Be the first to share your experience!

Sign in to leave a review for Dr. Elysa Widjaja

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1184331522
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 04, 2022
Last Update: February 12, 2026
Sole Proprietor: Yes

Mailing Address

3333 Burnet Ave, Ml 5031

Cincinnati, OH 452293026

Phone: 5136364251

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.