Active NPI
Bruce Michael Morse, MD
- Nephrology Physician
- San Pablo, CA
National Provider Identifier
1427325760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- G23287
- Practice address
- 14020 San Pablo Ave
Suite a
San Pablo, CA 94806-3619 - Phone
- (510) 235-1057
- NPI assigned
- Nov 30, 2011
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | G23287 | CA | Primary |
Addresses
Primary practice location
14020 San Pablo Ave
Suite a
San Pablo, CA 94806-3619
Mailing address
149 Chapel Dr
Mill Valley, CA 94941-3168
Phone (415) 383-3560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G23287 | Other | CA | CALIFORNIA LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160317001262 | CA | Order and Referring Only - Internal Medicine | 3173829157 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G23287 | CA | MD | Nephrology Physician |
| 23287 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Bay Nephrology Medical Group, Inc. | Nephrology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Nephrology Physician
- Berkeley, CA
- NPI 1871699074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1427325760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 CHAPEL DR",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949413168",
"telephone_number": "415-383-3560",
"fax_number": "415-383-7086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14020 SAN PABLO AVE",
"address_2": "SUITE A",
"city": "SAN PABLO",
"state": "CA",
"postal_code": "948063619",
"telephone_number": "510-235-1057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORSE",
"first_name": "BRUCE",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-30",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "CA",
"license": "G23287",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA LICENSE",
"identifier": "G23287",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Pablo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.