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JESSE JITTRIKAWIPHOL D.O.
NPI 1902256852
Student in an Organized Health Care Education/Training Program in Colton, CA

Active since June 21, 2016PECOS EnrolledAccepts Medicare Assignment
400 N PEPPER AVE, COLTON, CA 92324(855) 422-8029 Get Directions Write a Review

NPPES record last updated: November 23, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 23, 2021, Jun 21, 2016 (2 updates tracked since 2016).

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

NPI1902256852
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJESSE JITTRIKAWIPHOLCredential: D.O.
Location Address400 N PEPPER AVEColton, CA 92324-1801
Mailing Address400 N Pepper AveColton, CA 92324-1801 · (855) 422-8029
Phone(855) 422-8029
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateJune 21, 2016
Last NPPES UpdateNovember 23, 20212 updates tracked since enumeration
NPPES CertifiedNovember 23, 2021
✔ NPI 1902256852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
400 N PEPPER AVE, Colton, CA 92324
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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 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.

PECOS PAC ID1355683830
PECOS Enrollment IDI20190502001702
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.

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.

CATHERINE J CALHOUN
Licensed Psychiatric Technician
400 N PEPPER AVE
COLTON, CA 92324
San Bernardino County (909) 580-1800
CINDY COZART
Registered Nurse (Psychiatric/Mental Health)
400 N PEPPER AVE
COLTON, CA 92324
San Bernardino County (909) 580-1800
ARROWHEAD REGIONAL MEDICAL CENTER
General Acute Care Hospital
400 N PEPPER AVE
COLTON, CA 92324
San Bernardino County (909) 580-1000
LINDA MATTHEWS
Registered Nurse
400 N PEPPER AVE
COLTON, CA 92324
San Bernardino County (909) 580-3144
BRANDI DEUEL
Registered Nurse
400 N PEPPER AVE
COLTON, CA 92324
San Bernardino County (909) 580-3144
CHIQUE LOU FLORES RN
Registered Nurse
400 N PEPPER AVE
COLTON, CA 92324
San Bernardino County (909) 580-1800
KEVIN THIEN ONG
Student in an Organized Health Care Education/Training Program
400 N PEPPER AVE
COLTON, CA 92324
San Bernardino County (510) 525-6927
CAROLYN M DOHERTY MD
Otolaryngology
400 N PEPPER AVE, MOB SUITE 308
COLTON, CA 92324
San Bernardino County (909) 580-3353

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.

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.