Doctor profile · Federal record

Dr. Momodu Jack, M.D.

Gastroenterology Physician (CMS: Gastroenterology) · Gastroenterology Physician · Gastroenterology Physician · Washington, DC

  • NPI 1164521019
  • Accepts Medicare
  • 41 yrs in practice
  • Licensed in 3 states
  • Male
  • Solo practice
  • No sanctions

Practice & contact

Operates at 2 locations .

NPPES Updated May 11, 2026
Primary practice
2139 Georgia Ave Nw, Suite 3A
Washington, DC 200013035
(202) 865-7981
fax (301) 621-5313
Additional location
541 Sunset Ln Ste 301
Culpeper, VA 227013979
(540) 825-4557
fax (540) 825-4566
Mailing address
Po Box 2325
Columbia, MD 210451325

Credentials & registration

NPPES · NUCC
NPI registered
September 2006 — 20 yrs on file
Profile last updated
November 6, 2020
Year of graduation
1985 — 41 yrs since
Specialty taxonomy
207RG0100X — NUCC code
State licenses (3)
District of Columbia #MD20286 · Maryland #D0044035 · Virginia #0101270422
Medicaid (2)
MD #174961700 · DC #018868500

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1164521019. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
193
Distinct HCPCS
8
Medicare allowed
$33,513
HCPCS Description Services Patients Avg allowed
99204 New patient office or other outpatient visit, 45-59 minutes 48 48 $187
99214 Established patient office or other outpatient visit, 30-39 minutes 43 39 $143
45380 Biopsy of large bowel using a flexible endoscope 32 31 $119
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare 21 20 $278
45378 Diagnostic exam of large bowel using a flexible endoscope 14 14 $203
99215 Established patient office or other outpatient visit, 40-54 minutes 13 13 $200
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 11 11 $97
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk 11 11 $202

In context: peer comparison

Among 24 peers in Washington Gastroenterology Physician, average services per provider: 72. This provider delivers 2.7× the peer median.

Medicare Part D · 2023

Top prescriptions

CMS Part D Prescriber
Total claims
204
Patients
183
Total drug cost
$3,913
Drug Type Claims Patients Total cost
Peg 3350-Electrolyte (Sodium Chloride/Nahco3/Kcl/Peg) Brand 75 74 $1,524
Gavilyte-C (Peg3350/Sod Sulf,Bicarb,Cl/Kcl) Brand 49 48 $780
Gavilyte-G (Peg3350/Sod Sulf,Bicarb,Cl/Kcl) Brand 26 26 $501
Omeprazole Generic 26 20 $530
Peg-3350 and Electrolytes (Peg3350/Sod Sulf,Bicarb,Cl/Kcl) Brand 15 15 $290
Famotidine Generic 13 0 $289

Frequently asked questions

Auto-generated from federal data
What is Dr. Momodu Jack's medical specialty?
Dr. Momodu Jack practices Gastroenterology Physician in Washington, DC.
Where does Dr. Momodu Jack practice?
Dr. Momodu Jack practices at 2139 Georgia Ave Nw, Washington, DC 200013035. Office phone: 2028657981.
What is Dr. Momodu Jack's NPI?
Dr. Momodu Jack's National Provider Identifier (NPI) is 1164521019, issued by NPPES.
Does Dr. Momodu Jack accept Medicare assignment?
Yes. Dr. Momodu Jack accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Momodu Jack commonly perform?
Top Medicare-reported procedures in 2023: New patient office or other outpatient visit (HCPCS 99204); Established patient office or other outpatient visit (HCPCS 99214); Biopsy of large bowel using a flexible endoscope (HCPCS 45380). Source: CMS Medicare Physician & Other Practitioners file.