Individual provider Active NPI

Brian Edgar Neal, M.D.

  • Psychiatry Physician
  • Tacoma, WA
National Provider Identifier
1114284270
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD60641525 Issued in WA
Practice address
3402 S 19TH St
Tacoma, WA 98405-2487
Phone
(253) 301-5400
NPI assigned
Apr 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 252712 MA
Psychiatry Physician 2084P0800X MD60641525 WA Primary

Addresses

Primary practice location

3402 S 19TH St
Tacoma, WA 98405-2487

Mailing address

3402 S 19TH St
Tacoma, WA 98405-2487
Phone (253) 301-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160627001664 WA Practitioner - Psychiatry 9436381522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, San Diego School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance for South Sound HealthGroup PAC ID 5395094197, 9 clinicians

Practice addresses (Care Compare)

3402 S 19TH St
Tacoma, WA 98405-2487
Phone (253) 301-5400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60641525WAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jun 24, 2017 Accepting new patients
Alliance for South Sound Health CurrentSince Jan 26, 2020 Accepting new patients
Bournewood Clinical Associates Psychiatry CurrentSince Oct 10, 2015 Accepting new patients
Multicare Health System CurrentSince Jun 24, 2017 Accepting new patients

Locations

300 South St
Chestnut Hill, MA 02467
Phone (617) 469-0300

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

3402 S 19th St
Tacoma, WA 98405
Phone (253) 301-5400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1114284270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 S 19TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052487",
            "telephone_number": "253-301-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 S 19TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052487",
            "telephone_number": "253-301-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "BRIAN",
        "middle_name": "EDGAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-13",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "252712",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60641525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.