JESSE JITTRIKAWIPHOL D.O.
NPI 1902256852
Student in an Organized Health Care Education/Training Program in Colton, CA
About Jesse Jittrikawiphol D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSE JITTRIKAWIPHOL D.O. (NPI 1902256852) is an individual student in an organized health care education/training program in Colton, California and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
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
Jesse Jittrikawiphol D.o. 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.
Medicare Billing Reassignment
Medicare enrollment records show Jesse Jittrikawiphol reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fontana, CA 92335
- Reassigned Medicare billing, California enrollment
- Also billed through NPI 1952333460 (California)
- 5,228 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
COLTON, CA 92324
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 Jesse Jittrikawiphol's NPI number?
The NPI number for Jesse Jittrikawiphol is 1902256852. It was assigned to this individual provider in the NPPES registry on June 21, 2016.
Where is Jesse Jittrikawiphol located?
Jesse Jittrikawiphol practices at 400 N Pepper Ave, Colton, CA 92324. The listed phone number is (855) 422-8029.
What is Jesse Jittrikawiphol's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Jesse Jittrikawiphol enrolled in Medicare?
Yes. Jesse Jittrikawiphol 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 Jesse Jittrikawiphol's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jesse Jittrikawiphol reassigns Medicare benefits to Southern California Permanente Medical Group (Fontana, 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 Jesse Jittrikawiphol'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 Jesse Jittrikawiphol was last updated on November 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Jesse Jittrikawiphol, D.O. · NPI 1902256852
Student in an Organized Health Care Education/Training Program provider in Colton, California. Individual provider, active in the CMS NPPES registry since June 21, 2016.
## Identity
- **NPI:** 1902256852 (Entity type: Individual)
- **Enumerated:** June 21, 2016
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 400 N PEPPER AVE, Colton, CA 92324-1801
- **Phone:** (855) 422-8029
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1689606196, Fontana, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** November 23, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1902256852) · Data from the CMS NPPES public registry.