Individual provider Active NPI

Jaibir Singh Pannu, MD

  • Otolaryngology Physician
  • Riverside, CA
National Provider Identifier
1396372470
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A188513 Issued in CA
Practice address
6848 Magnolia Ave Ste 220
Riverside, CA 92506-2858
Phone
(909) 558-2600
NPI assigned
Mar 26, 2020
Last updated
Jun 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A188513 CA Primary

Addresses

Primary practice location

6848 Magnolia Ave Ste 220
Riverside, CA 92506-2858

Mailing address

6848 Magnolia Ave Ste 220
Riverside, CA 92506-2858
Phone (951) 981-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250715003138 CA Practitioner - Otolaryngology 7113432469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgent Head and Neck Surgeons IncGroup PAC ID 6103246434, 6 clinicians

Practice addresses (Care Compare)

6848 Magnolia Ave
Suite 220
Riverside, CA 92506-2858
Phone (951) 981-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgent Head and Neck Surgeons, Inc. Otolaryngology CurrentSince Aug 1, 2025 Accepting new patients

Locations

6848 Magnolia Ave
Ste 220
Riverside, CA 92506
Phone (951) 683-1166

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1396372470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6848 MAGNOLIA AVE STE 220",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062858",
            "telephone_number": "951-981-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6848 MAGNOLIA AVE STE 220",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062858",
            "telephone_number": "909-558-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNU",
        "first_name": "JAIBIR",
        "middle_name": "SINGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A188513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.