Stacey Rayelle Brenner, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

400 Parnassus Ave Ste A405
San Francisco, CA 94143-2202

Phone

(415) 476-4990

Fax

(415) 476-7964

NPI assigned

Nov 9, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: stacey.brenner.p1@direct.lakeside.nextgenshare.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.

• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642
  Medicare reassignment

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1386971505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PARNASSUS AVE STE A405",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432202",
            "telephone_number": "415-476-4990",
            "fax_number": "415-476-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PARNASSUS AVE STE A405",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432202",
            "telephone_number": "415-476-4990",
            "fax_number": "415-476-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "STACEY",
        "middle_name": "RAYELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-09",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Michael Brenner, PHARM.D.
• Jennifer Kate Brenner
• Jill F Brenner, PT, DPT, ATC, OCS
• Laurence Brenner, PHD
• Richard J. Brenner, MD
• Cheryl Marie Brent-Simmons
• Bruce N Brent, MD
• Richard Lawrence Brent, D.C.
• Kaila Alexandra Spafford Brereton, AC-PNP
• Oxana Bresker

• Student in an Organized Health Care Education/Training Program in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.