Forrest C. Jellison, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A98781 Issued in CA

Practice address

11370 Anderson St Ste 1100
Loma Linda, CA 92354

Phone

(909) 558-4196

Fax

(909) 558-4806

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

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 2

Specialty

Urology

Education

Loma Linda University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Faculty Physicians and Surgeons of LlusmGroup PAC ID 1153227814, 1,313 clinicians

Beaver Medical Group P CGroup PAC ID 0547164295, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327
• Riverside University Health System-Medical Center Hospital, Moreno Valley, CA, CCN 050292
• Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245
• Redlands Community Hospital Hospital, Redlands, CA, CCN 050272

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: fjellison261481@direct.llu.edu
• Direct secure messaging: fjellison11234@epiclp.direct-ci.com

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

• Beaver Medical Group P C

  dba Optum

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1649503319

  Urology

  Medicare reassignment Care Compare group NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment Care Compare group NPD
• Sac Health System

  dba SAC Arrowhead

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1013935923
  Medicare reassignment NPD
• Texas Urology Group, PA

  • Urology Physician
  • San Antonio, TX
  • NPI 1134586415
  Medicare reassignment NPD
• Beaver Medical Group P C

  • Physical Therapist
  • Redlands, CA
  • NPI 1427090281
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatric Cardiology Physician
  • Beaumont, CA
  • NPI 1871766121
  NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1467274126
  NPD
• Sac Health System

  dba Sac San Bernardino Campus

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1801270137
  NPD
• Beaver Medical Group P C

  dba Beaver Advantage Health Center

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1275570830
  NPD (past)
• Faculty Physicians and Surgeons of Llusm

  • Orthopaedic Surgery Physician
  • Loma Linda, CA
  • NPI 1275582918
  NPD (past)
• Loma Linda University Children's Hospital

  • Children's Hospital
  • Loma Linda, CA
  • NPI 1366866345
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• County of Riverside

  • General Acute Care Hospital
  • Moreno Valley, CA
  • NPI 1821159195
  Care Compare affiliation
• County of San Bernardino

  dba Arrowhead Regional Medical Center

  • General Acute Care Hospital
  • Colton, CA
  • NPI 1720158009
  Care Compare affiliation
• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  Care Compare affiliation
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  Care Compare affiliation

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1508073511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE 1100",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-4196",
            "fax_number": "909-558-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE 1100",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-558-4196",
            "fax_number": "909-558-4806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11370 Anderson St Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "92354",
            "country_code": "US",
            "telephone_number": "909-558-4196 x44196",
            "fax_number": "909-558-4806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3551 Roger Brooke Drive Bldg 3600 MCHE-SDU",
            "address_2": "San Antonio Military Medical Center",
            "address_purpose": "LOCATION",
            "city": "Jbsa Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "310-794-0206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JELLISON",
        "first_name": "FORREST",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A98781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmanuel Jeffrey III, OD, DRPH, MPH
• Niranjan Jeganathan, M.D.
• Akinlolu Tolulope Jegede, DDS
• Omar Jeiroudi, MD
• Rami Ramzi Jekki, D.D.S.
• Leo C Jeng, M.D.
• Louis Jenkins, PHD
• Soh Jeon
• Won Jin Jeon, MD
• Ye Jin Jeon, MD

• Urology Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.