Brian Mack, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5011498 Issued in NC

Practice address

655 Montgomery St Ste 810
San Francisco, CA 94111-2677

Phone

(844) 847-8216

Fax

(415) 520-9150

NPI assigned

Feb 25, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, FL, ID, AL, KS, CO, MI, GA, WV, KY, DE, VA, LA, NH, OK, TN, MT, OH, ME, VT, MD, ND, SD, TX, NM, IA, MS, WY, UT, CT, WI, AK, CA, NJ, RI, MO, DC, IL, AR, AZ, HI, NV, OR, IN, SC, NY, PA, MA, MN49 enrollments

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 49

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bmack48185@direct.conehealth.com

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.

• Moses Cone Medical Services, Inc.

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1427095249

  Pulmonary Disease

  Medicare reassignment NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1013265909
  Medicare reassignment NPD
• Virta Medical P.C.

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1093225138

  AK, AL, AR, AZ, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WI, WV, WY

  Medicare reassignment
• Moses Cone Medical Services, Inc.

  • Family Medicine Physician
  • Madison, NC
  • NPI 1629376363
  NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Community/Retail Pharmacy
  • Eden, NC
  • NPI 1861222507
  NPD
• Healthtap Medical Group, P.C.

  • General Practice Physician
  • Portola Valley, CA
  • NPI 1518330539
  NPD (past)
• Ready Responders Pennsylvania LLC

  • General Practice Physician
  • Lansdale, PA
  • NPI 1194341214
  NPD (past)

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1063979128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 QUINCEMOOR CT",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274077789",
            "telephone_number": "336-840-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 MONTGOMERY ST STE 810",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941112677",
            "telephone_number": "844-847-8216",
            "fax_number": "415-520-9150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5001 Quincemoor Ct",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274077789",
            "country_code": "US",
            "telephone_number": "336-840-8338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-25",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "5011498",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NC",
            "license": "5011498",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5011498",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esperanza Eva Macias
• Raymundo Macias
• Yazmin Macias
• Julia Macisaac, MD
• Alonzo Mack
• Don Mack, MFT
• Kimi Mack, LMFT, LPCC
• Althea Faye Mackay
• Brennan Mackay
• Krystina Mackenzie

• Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.