Individual provider Active NPI

Jon Persichino, D.O.

  • Infectious Disease Physician
  • Riverside, CA
National Provider Identifier
1619905189
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
20A8923 Issued in CA
Practice address
7117 Brockton Ave
Riverside, CA 92506-2658
Phone
(951) 782-3694
Fax
(951) 784-3272
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A8923 CA
Infectious Disease Physician 207RI0200X 20A8923 CA Primary

Addresses

Primary practice location

7117 Brockton Ave
Riverside, CA 92506-2658

Mailing address

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 782-3694

Other practice location 1

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-5700

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
I20180813002455 CA Practitioner - Infectious Disease 7517976657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Western University of Health Sciences College of Dental Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 683-6370

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8923CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc Internal Medicine CurrentSince Jun 30, 2018 Accepting new patients
Riverside Medical Clinic, Inc Current Accepting new patients
Uhs Corona Inc Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients

Locations

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1619905189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-3694",
            "fax_number": "951-784-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-3694",
            "fax_number": "951-784-3272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26520 Cactus Ave",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925553927",
            "country_code": "US",
            "telephone_number": "951-486-5700",
            "fax_number": "951-486-5705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERSICHINO",
        "first_name": "JON",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A8923",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "20A8923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.