Individual provider Active NPI

Jonathan Jinesta, PA

  • Physician Assistant
  • Lynwood, CA
National Provider Identifier
1811535222
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57759 Issued in CA
Practice address
3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone
(310) 900-8900
NPI assigned
Dec 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57759 CA Primary

Addresses

Primary practice location

3630 E Imperial Hwy
Lynwood, CA 90262-2609

Mailing address

7208 Riley Dr
Fontana, CA 92336-5749
Phone (909) 275-4768

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200319000456 CA Practitioner - Physician Assistant 4082042411 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity Physician Services PCGroup PAC ID 0749620888, 58 clinicians

Practice addresses (Care Compare)

1499 E Highland Ave
San Bernardino, CA 92404-4611
Phone (855) 422-8029

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57759CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity Physician Services PC CurrentSince Nov 3, 2025 Accepting new patients
Cep America-California CurrentSince Mar 1, 2020 Accepting new patients
Cep America - California CurrentSince Oct 11, 2021 Accepting new patients
Nellie Gail Urgent Care Past Accepting new patients
Careathome Medical Practice Ca PC PastSince Sep 1, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1499 E Highland Ave
Sn Bernrdno, CA 92404
Phone (855) 422-8029

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Interoperability endpoints

  • Direct secure messaging: jjinesta1103097@direct.llu.edu

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1811535222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7208 RILEY DR",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365749",
            "telephone_number": "909-275-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622609",
            "telephone_number": "310-900-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JINESTA",
        "first_name": "JONATHAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-16",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.