Individual provider Active NPI

Brian Raye Collins, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1063647576
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A107833 Issued in CA
Practice address
1200 N State St
Ird 620
Los Angeles, CA 90033-1029
Phone
(323) 226-7556
NPI assigned
May 28, 2009
Last updated
May 28, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A107833 CA Primary

Addresses

Primary practice location

1200 N State St
Ird 620
Los Angeles, CA 90033-1029

Mailing address

333 S Catalina St
Apt 429
Los Angeles, CA 90020-2028
Phone (541) 264-9150

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
I20101118000772 CA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 8921294802 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Howard University College of Medicine, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Northeast Valley Health CorporationGroup PAC ID 3173517323, shared by 14 NPIs, 77 clinicians

Practice addresses (Care Compare)

12756 Van Nuys Blvd
Pacoima, CA 91331-1626
Phone (818) 896-0531

14624 Sherman Way
Van Nuys, CA 91405-2241
Phone (818) 988-6335

1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone (818) 365-8086

23763 Valencia Blvd
Valencia, CA 91355-2105
Phone (661) 287-1551

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A107833CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of California, PC CurrentSince Sep 7, 2024 Accepting new patients
Northeast Valley Health Corporation CurrentSince Oct 5, 2022 Accepting new patients
Northeast Valley Health Corporation CurrentSince Oct 5, 2022 Accepting new patients
Northeast Valley Health Corporation Current Accepting new patients

Locations

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656

1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388

1600 San Fernando Rd
San Fernando, CA 91340
Phone (818) 365-8086

505 Montgomery St
Fl 10
San Francisco, CA 94111
Phone (503) 427-8095

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: bcollins181876@direct.llu.edu
  • Direct secure messaging: brian.collins.p1@direct.nevhc.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1063647576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S CATALINA ST",
            "address_2": "APT 429",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900202028",
            "telephone_number": "541-264-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "IRD 620",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "BRIAN",
        "middle_name": "RAYE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-28",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A107833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.