Brian Wallace Dorman, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

G24506 Issued in CA

Practice address

2576 Renfren Street
Eureka, CA 95501

Phone

(707) 445-3257

Fax

(707) 445-1027

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bdorman1657653@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 and National Provider Directory roles.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment NPD (past)
• Telehealth Specialty Medical Group

  dba TeleMed2U

  • Emergency Medicine Physician
  • Roseville, CA
  • NPI 1326338237
  Medicare reassignment
• Providence Medical Foundation

  • Urology Physician
  • Apple Valley, CA
  • NPI 1053616706
  NPD
• Providence Medical Foundation

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

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Urology Associates of the Humboldt Nation, AMC

  • Urology Physician
  • Eureka, CA
  • NPI 1922138999
  NPD
• Mad River Community Anesthesia Medical Group

  • Pain Medicine (Anesthesiology) Physician
  • Arcata, CA
  • NPI 1578599619
  NPD (past)
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  NPD (past)
• Tele-Medicine Services Ny, PLLC

  • Internal Medicine Physician
  • Roseville, CA
  • NPI 1609663780
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1447278122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2576 RENFREN STREET",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "95501",
            "telephone_number": "707-445-3257",
            "fax_number": "707-445-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2576 RENFREN STREET",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "95501",
            "telephone_number": "707-445-3257",
            "fax_number": "707-445-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "BRIAN",
        "middle_name": "WALLACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G24506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdorman1657653@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2576 Renfren Street",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdorman1657653@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2700 Dolbeer St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955014736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cecilie-Joy L Domingo
• Rachel Donohue, MD
• Kelsey Donovan
• Jessica Dora, AMFT
• Louise Dorgan, RN
• Douglas H. Lanning, O.D.
• James Douglas
• Morgan Douglas
• Joseph Doumakis, REGISTERED NURSE
• Jesica Emily Dowdy, SUDRC# 18226

• Urology Physician in Eureka, CA
• Providers in Eureka, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.