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JISHA PANGOTTIL
NPI 1871073411
Nurse Practitioner - Primary Care in Ontario, CA

Active since August 14, 2018PECOS Enrolled
2295 S VINEYARD AVE, ONTARIO, CA 91761(909) 724-3940 Get Directions Write a Review

NPPES record last updated: August 14, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jisha Pangottil NPPES

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

JISHA PANGOTTIL (NPI 1871073411) is an individual primary care provider in Ontario, California, licensed in California (NP95009215) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871073411
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameJISHA PANGOTTIL
Location Address2295 S VINEYARD AVEOntario, CA 91761-7925
Mailing Address2295 S Vineyard AveOntario, CA 91761-7925
Phone(909) 724-3940
Sole ProprietorNo
Enumeration DateAugust 14, 2018
✔ NPI 1871073411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in CA · NP95009215
2295 S VINEYARD AVE, Ontario, CA 91761
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 (PECOS)

Jisha Pangottil is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Jisha Pangottil reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Unicare Community Health Center Inc
1.4 mi
Federally Qualified Health Center (FQHC)
1151 E WALNUT ST
Ontario, CA 91761
  • Reassigned Medicare billing, California enrollment
  • 119 clinicians in this Medicare group
NPI 1215494257 (909) 467-1425

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 91761 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.

DR. BENJAMIN MAURICE KERSHBERG M.D.
Pediatrics
2295 S VINEYARD AVE, MOB A
ONTARIO, CA 91761
San Bernardino County (909) 724-2554
MS. CHRISTINE RAMOS PHARM.D.
Pharmacist
2295 S VINEYARD AVE
ONTARIO, CA 91761
San Bernardino County (909) 724-7640
DORIS WU
Pharmacist
2295 S VINEYARD AVE
ONTARIO, CA 91761
San Bernardino County (909) 724-3120
LINA SALEHIAN
Pharmacist
2295 S VINEYARD AVE
ONTARIO, CA 91761
San Bernardino County (909) 724-2126
JENNIFER RHEE
Pharmacist
2295 S VINEYARD AVE
ONTARIO, CA 91761
San Bernardino County (909) 724-3500
MANUEL JOSE SALAS PHARM.D.
Pharmacist
2295 S VINEYARD AVE
ONTARIO, CA 91761
San Bernardino County (909) 724-7640
THUONG VU FNP
Nurse Practitioner (Family)
2295 S VINEYARD AVE
ONTARIO, CA 91761
San Bernardino County (833) 574-2273
LIAN LIU MPH, RD, CDE
Dietitian, Registered
2295 S VINEYARD AVE
ONTARIO, CA 91761
San Bernardino County (909) 724-5000

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 Jisha Pangottil's NPI number?

The NPI number for Jisha Pangottil is 1871073411. It was assigned to this individual provider in the NPPES registry on August 14, 2018.

Where is Jisha Pangottil located?

Jisha Pangottil practices at 2295 S Vineyard Ave, Ontario, CA 91761. The listed phone number is (909) 724-3940.

What is Jisha Pangottil's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Jisha Pangottil enrolled in Medicare?

Yes. Jisha Pangottil is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jisha Pangottil's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jisha Pangottil reassigns Medicare benefits to Unicare Community Health Center Inc (Ontario, 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 Jisha Pangottil'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 Jisha Pangottil was last updated on August 14, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.