Individual provider Active NPI

Justin Lee Yanuck, M.D.

  • Emergency Medicine Physician
  • Downey, CA
National Provider Identifier
1235592478
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A152948 Issued in CA
Practice address
9333 Imperial Hwy
Downey, CA 90242-2812
Phone
(562) 657-7116
NPI assigned
Apr 4, 2016
Reactivated
Dec 18, 2024
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X A152948 CA
Emergency Medicine Physician 207P00000X A152948 CA Primary
Emergency Medicine Physician 207P00000X 278535 MA

Addresses

Primary practice location

9333 Imperial Hwy
Downey, CA 90242-2812

Mailing address

9333 Imperial Hwy
Downey, CA 90242-2812
Phone (562) 657-7116

Other practice location 1

55 Fruit St
Boston, MA 02114-2621
Phone (617) 643-2652

Other practice location 2

55 Fruit St
Boston, MA 02114-2621
Phone (617) 643-2652

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20200824003472 CA Practitioner - Interventional Pain ManagementPractitioner - Emergency Medicine 1850646480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Emergency Medicine
Education
University of California, Irvine, California College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renew Health Medical CorporationGroup PAC ID 3375063837, 2 clinicians

Practice addresses (Care Compare)

30230 Rancho Viejo Rd
Suite 134
San Juan Capistrano, CA 92675-1585
Phone (949) 445-1898

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
278535MAMDEmergency Medicine Physician
A152948CAMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renew PC Emergency Medicine CurrentSince Nov 27, 2022 Accepting new patients
Renew Health Medical Corporation Emergency Medicine CurrentSince Dec 22, 2024 Accepting new patients

Locations

30230 Rancho Viejo Rd
Ste 134
San Juan Capistrano, CA 92675
Phone (949) 371-7856

17581 Irvine Blvd
Ste 114
Tustin, CA 92780
Phone (586) 925-3734

Interoperability endpoints

  • Direct secure messaging: justin.yanuck.p44@direct.omnieyeatlanta.nextgenshare.com

Organizations & group practices 2

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.

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1235592478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9333 IMPERIAL HWY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422812",
            "telephone_number": "562-657-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9333 IMPERIAL HWY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422812",
            "telephone_number": "562-657-7116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-643-2652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-643-2652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANUCK",
        "first_name": "JUSTIN",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "deactivation_date": "2024-11-20",
        "reactivation_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A152948",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A152948",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "278535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.