JONATHAN IM
NPI 1932801131
Student in an Organized Health Care Education/Training Program in Riverside, CA

Q: What is Jonathan Im's NPI number?

The NPI number for Jonathan Im is 1932801131. It was assigned to this individual provider in the NPPES registry on March 20, 2023.

Q: What is Jonathan Im's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Im was last updated on March 22, 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.

Active since March 20, 2023PECOS Enrolled

4445 MAGNOLIA AVE, RIVERSIDE, CA 92501(951) 788-3000 Get Directions Write a Review

NPPES record last updated: March 22, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Jonathan Im NPPES

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

JONATHAN IM (NPI 1932801131) is an individual student in an organized health care education/training program in Riverside, California and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1932801131

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJONATHAN IM

Location Address4445 MAGNOLIA AVERiverside, CA 92501-4135

Mailing Address1000 Sunset Hills LnRedlands, CA 92373-6960

Phone(951) 788-3000

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateMarch 20, 2023

Last NPPES UpdateMarch 22, 2023

NPPES CertifiedMarch 22, 2023

✔ NPI 1932801131 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.

4445 MAGNOLIA AVE, Riverside, CA 92501

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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)

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

PECOS PAC ID2264996511

PECOS Enrollment IDI20260708003754

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.

MR. DAVID W LEVINE PA-C

Physician Assistant