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

Q: 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.

Q: What is Jisha Pangottil's specialty?

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

Q: 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.

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: August 16, 2026.

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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

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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