Individual provider Active NPI

Ryan Junsay, PA-C

  • Medical Physician Assistant
  • Riverside, CA
National Provider Identifier
1750424248
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA17137 Issued in CA
Practice address
4234 Riverwalk Pkwy Ste 230
Riverside, CA 92505-3312
Phone
(951) 781-3672
Fax
(951) 781-0365
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA17137 CA Primary

Addresses

Primary practice location

4234 Riverwalk Pkwy Ste 230
Riverside, CA 92505-3312

Mailing address

4234 Riverwalk Pkwy Ste 230
Riverside, CA 92505-3312
Phone (951) 781-3672

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
I20050411001342 CA Practitioner - Physician Assistant 7810934874 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA17137CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Professional Surgical Group Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397692800000",
    "number": "1750424248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 RIVERWALK PKWY STE 230",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053312",
            "telephone_number": "951-781-3672",
            "fax_number": "951-781-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4234 RIVERWALK PKWY STE 230",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053312",
            "telephone_number": "951-781-3672",
            "fax_number": "951-781-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNSAY",
        "first_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2014-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.