Individual provider Active NPI

Macey Yates Johnson

  • Emergency Medicine Physician
  • Temecula, CA
National Provider Identifier
1902487440
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A186559 Issued in CA
Practice address
31700 Temecula Pkwy Ste 1
Temecula, CA 92592-5896
Phone
(951) 331-2535
NPI assigned
Apr 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X A186559 CA Primary

Addresses

Primary practice location

31700 Temecula Pkwy Ste 1
Temecula, CA 92592-5896

Mailing address

31700 Temecula Pkwy Ste 1
Temecula, CA 92592-5896

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
I20240613004448 CA Practitioner - Emergency Medicine 8426591884 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Maryland School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temecula Valley Emergency Physicians IncGroup PAC ID 2769619097, 20 clinicians

Practice addresses (Care Compare)

31700 Temecula Pkwy
Temecula, CA 92592-5896
Phone (951) 331-2280

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A186559CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Em Alliance California, Apc Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Temecula Valley Emergency Physicians, Inc Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

38600 Medical Center Dr
Palmdale, CA 93551
Phone (661) 382-5000

31700 Temecula Pkwy
Ste 1
Temecula, CA 92592
Phone (951) 331-2527

31700 Temecula Pkwy
Temecula, CA 92592
Phone (951) 303-8939

36485 Inland Valley Dr
Wildomar, CA 92595
Phone (909) 677-9778

L4421
Columbus, OH 43260

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.

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": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1902487440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31700 TEMECULA PKWY STE 1",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31700 TEMECULA PKWY STE 1",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925896",
            "telephone_number": "951-331-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MACEY",
        "middle_name": "YATES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A186559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.