Individual provider Active NPI

Jonathan Garth Briskin, M.D.

  • Cardiovascular Disease Physician
  • San Mateo, CA
National Provider Identifier
1417032376
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G31838 Issued in CA
Practice address
101 S San Mateo Dr
Ste 213
San Mateo, CA 94401-3843
Phone
(650) 373-0170
Fax
(650) 347-8966
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G31838 CA Primary

Addresses

Primary practice location

101 S San Mateo Dr
Ste 213
San Mateo, CA 94401-3843

Mailing address

101 S San Mateo Dr
Ste 213
San Mateo, CA 94401-3843
Phone (650) 373-0170

Other identifiers 1

IdentifierTypeStateIssuer
00G318381MedicaidCA

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
I20120206000093 CA Practitioner - Cardiovascular Disease (Cardiology) 5597922419 Practice locations: San Mateo, CA

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
New York University School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

101 S San Mateo Dr
San Mateo, CA 94401-3843
Phone (650) 373-0170

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31838CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Past Accepting new patients
Palo Alto Medical Foundation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jbriskin48040@hisp.ehr.sutterhealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417032376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S SAN MATEO DR",
            "address_2": "STE 213",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013843",
            "telephone_number": "650-373-0170",
            "fax_number": "650-347-8966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S SAN MATEO DR",
            "address_2": "STE 213",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013843",
            "telephone_number": "650-373-0170",
            "fax_number": "650-347-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISKIN",
        "first_name": "JONATHAN",
        "middle_name": "GARTH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G31838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G318381",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.