STEFAN R JIBODH (M.D.) – Adult Reconstructive Orthopaedic Surgery Physician, NPI 1508875642

STEFAN R JIBODH (M.D.) is a healthcare provider. based in Walnut creek, California. specializing in ORTHOPEDIC SURGERY, HAND SURGERY. They hold the professional credentials M.D.. They hold a License No. A104528 (CA). The NPI Number for STEFAN R JIBODH (M.D.) is 1508875642

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
STEFAN R JIBODH (M.D.)
NPI
1508875642
Phone
(925) 295-4130
Address
1425 S MAIN ST
Enumeration Date
7 August 2006
Last Update Date
14 December 2021

Doctor Profile

Medical School Name
JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9252954000
Graduation Year
2002 (24 years ago)
PAC ID
2466546999
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20110426000769
Address ID
CA945965120WA1515XAVEX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

3,024 ORTHOPEDIC SURGERY in CA

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Provider Addresses for STEFAN R JIBODH (M.D.)

  • 45B, 1425, South Main Street, Walnut Creek, Contra Costa County, California, 94596, United States

    DEPT OF ORTHOPEDICS, MOB 1ST FLOOR

    WALNUT CREEK, CA 945965318

    Phone: (925) 295-4130

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 13 Open Payments records for all available years, with a total value of $1,338.

Total Amount is formed as General ($1,338) + Research ($0) + Ownership ($0) = $1,338.

Last reported payment date: 2024-08-13 • Largest payer in this snapshot: Zimmer Biomet Holdings, Inc. ($1,338).

Total Amount

$1,338

General + Research + Ownership

Payments

13

Total payment records

General Amount

$1,338

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Zimmer Biomet Holdings, Inc.$1,338
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-04-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110426000769IOrthopedic SurgeryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94596)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
Colorectal Surgery (Proctology), General SurgeryLA
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Emergency MedicineCA
-MA
Emergency MedicineCA

Reviews

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Frequently asked questions

What federal number belongs to STEFAN R JIBODH (M.D.)?
The federal identifier for STEFAN R JIBODH (M.D.) is NPI 1508875642.
Does this profile mean STEFAN R JIBODH (M.D.) is currently active?
Yes — STEFAN R JIBODH (M.D.) appears active in the national provider directory.
What field does STEFAN R JIBODH (M.D.) work in?
You can think of STEFAN R JIBODH (M.D.) as practicing within Adult Reconstructive Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
Where is STEFAN R JIBODH (M.D.)'s primary listing?
We display Walnut Creek, California because that is what the record indicates for STEFAN R JIBODH (M.D.).
Is STEFAN R JIBODH (M.D.) a real provider?
This page reflects official NPPES data for NPI 1508875642. Always confirm identity and privileges with the practice and licensing boards.

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