1. Home
  2. Directory
  3. California
  4. Riverside
  5. Nurse Practitioner
  6. NPI Profile

LUCYANA MAGRIETTA PANJAITAN NURSE PRACTITIONER
NPI 1831656578
Nurse Practitioner in Riverside, CA

Active since February 28, 2019PECOS EnrolledAccepts Medicare Assignment
4500 BROCKTON AVE, RIVERSIDE, CA 92501(951) 276-2760(951) 276-2960 Get Directions Write a Review

NPPES record last updated: September 26, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Lucyana Magrietta Panjaitan Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LUCYANA MAGRIETTA PANJAITAN NURSE PRACTITIONER (NPI 1831656578) is an individual nurse practitioner in Riverside, California, licensed in California (95007651) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1831656578
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameLUCYANA MAGRIETTA PANJAITANCredential: NURSE PRACTITIONER
Location Address4500 BROCKTON AVERiverside, CA 92501-4090
Mailing Address4500 Brockton AveRiverside, CA 92501-4090 · (951) 276-2760 · Fax (951) 276-2960
Phone(951) 276-2760
Fax(951) 276-2960
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateFebruary 28, 2019
Last NPPES UpdateSeptember 26, 2023
✔ NPI 1831656578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · 95007651
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
4500 BROCKTON AVE, Riverside, CA 92501
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lucyana Magrietta Panjaitan Nurse Practitioner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779949896
PECOS Enrollment IDI20230821000440
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lucyana Panjaitan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
6.9 mi
Health Maintenance Organization
10800 MAGNOLIA AVE
Riverside, CA 92505
  • Reassigned Medicare billing, California enrollment
  • 5,228 clinicians in this Medicare group
NPI 1316979834 (866) 984-7483

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RIVERSIDE RADIOLOGY MEDICAL GROUP INC
Radiology (Diagnostic Radiology)
4500 BROCKTON AVE, SUITE 219
RIVERSIDE, CA 92501
Riverside County (951) 276-7550
MISSION UROLOGY, INC.
Urology
4500 BROCKTON AVE, SUITE 301
RIVERSIDE, CA 92501
Riverside County (951) 276-4505
GEORGES ABOU RJAILI MD
Internal Medicine (Cardiovascular Disease)
4500 BROCKTON AVE, STE 203
RIVERSIDE, CA 92501
Riverside County (951) 686-3600
DR. STEVEN GODELMAN MD
Surgery (Trauma Surgery)
4500 BROCKTON AVE
RIVERSIDE, CA 92501
Riverside County (951) 788-3000
MR. EUGENE WILLIAM ALBRIGHT JR. M.D.
Obstetrics & Gynecology
4500 BROCKTON AVE, SUITE 315
RIVERSIDE, CA 92501
Riverside County (951) 781-7184
SRI GORTY M.D. INC
Radiology (Radiation Oncology)
4500 BROCKTON AVE, 101
RIVERSIDE, CA 92501
Riverside County (951) 788-3000
JOCELYN CASES
Nurse Practitioner (Family)
4500 BROCKTON AVE, SUITE 315
RIVERSIDE, CA 92501
Riverside County (951) 680-0909
BENJAMIN CHUNG MD
Internal Medicine
4500 BROCKTON AVE, SUITE 306
RIVERSIDE, CA 92501
Riverside County (951) 321-0100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lucyana Panjaitan's NPI number?

The NPI number for Lucyana Panjaitan is 1831656578. It was assigned to this individual provider in the NPPES registry on February 28, 2019.

Where is Lucyana Panjaitan located?

Lucyana Panjaitan practices at 4500 Brockton Ave, Riverside, CA 92501. The listed phone number is (951) 276-2760.

What is Lucyana Panjaitan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Lucyana Panjaitan enrolled in Medicare?

Yes. Lucyana Panjaitan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Lucyana Panjaitan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lucyana Panjaitan reassigns Medicare benefits to Southern California Permanente Medical Group (Riverside, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lucyana Panjaitan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lucyana Panjaitan was last updated on September 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.