Individual provider Active NPI

Bruce Michael Morse, MD

  • Nephrology Physician
  • San Pablo, CA
National Provider Identifier
1427325760
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G23287 Issued in CA
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, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
G23287OtherCACALIFORNIA 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160317001262 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3173829157

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G23287CAMDNephrology Physician
23287CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.