Brandon Eugene Bireley, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

20A16540 Issued in CA

Practice address

3307 Renner Dr
Fortuna, CA 95540-3119

Phone

(707) 725-7390

NPI assigned

Jun 27, 2013

Last updated

Oct 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

General Surgery

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
• Providence Redwood Memorial Hospital Hospital, Fortuna, CA, CCN 051318

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bbireley1657495@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph Health Northern California, LLC

  dba Providence Redwood Memorial Hospital

  • Critical Access Hospital
  • Fortuna, CA
  • NPI 1043292303
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Redwood Memorial Hospital

  • Critical Access Hospital
  • Fortuna, CA
  • NPI 1285849026
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Humboldt Home Infusion

  • Home Infusion Therapy Pharmacy
  • Eureka, CA
  • NPI 1568422319

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1891900635
  Care Compare affiliation

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1407296064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3307 RENNER DR",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 RENNER DR",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403119",
            "telephone_number": "707-725-7390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6245 Inkster Rd",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "MI",
            "postal_code": "481354001",
            "country_code": "US",
            "telephone_number": "734-458-4486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIRELEY",
        "first_name": "BRANDON",
        "middle_name": "EUGENE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101020721",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "20A16540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbireley1657495@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "3304 Renner Dr",
            "city": "Fortuna",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955407102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gary Hungerford Baker, M D
• Christy Rae Bascochea, RN
• Michael Peter Belluscio, D.D.S.
• Elaine K Bettiga, FNP
• Andrew Allen Billings, FNP
• Diederik-Jan Frederick Bouwmeester, PHARM.D.
• Ashley Megan Bramlett, RN
• Nathan Dario Brinckhaus
• Ruben E Brinckhaus, MD
• Broadway Medical Service & Supply, Inc

• Surgery Physician in Fortuna, CA
• Providers in Fortuna, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.