NPIMap

Organization Active NPI

Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
National Provider Identifier
1508325184
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BRIGHTSIDE MEDICAL, P.C.
Practice address
5214F Diamond Heights Blvd # 345
San Francisco, CA 94131-2175
Phone
(415) 360-3348
Fax
(855) 350-5708
NPI assigned
Mar 13, 2019
Last updated
Nov 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Authorized official

Name
Mirene Winsberg
Title
Administration
Phone
(415) 360-3348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

5214F Diamond Heights Blvd # 345
San Francisco, CA 94131-2175

Mailing address

2261 Market St Ste 10222
San Francisco, CA 94114-1612
Phone (415) 360-3348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, WA, NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20230418000266 PA Part B Supplier - Clinic/Group Practice 4082089461 Receives reassigned benefits from 28 practitioners
Practice locations: Harrisburg, PA
O20230628000619 WA Part B Supplier - Clinic/Group Practice 4082089461 Receives reassigned benefits from 7 practitioners
Practice locations: Olympia, WA
O20230803003025 NY Part B Supplier - Clinic/Group Practice 4082089461 Receives reassigned benefits from 45 practitioners
Practice locations: Syracuse, NY

National Provider Directory

National Provider Directory

Locations

2103 Harrison Ave NW
Olympia, WA 98502

Practitioners & affiliated clinicians

Practitioners 92

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 92

NPI Registry JSON

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1508325184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 MARKET ST STE 10222",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141612",
            "telephone_number": "415-360-3348",
            "fax_number": "855-350-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5214F DIAMOND HEIGHTS BLVD # 345",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941312175",
            "telephone_number": "415-360-3348",
            "fax_number": "855-350-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTSIDE MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-13",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "WINSBERG",
        "authorized_official_first_name": "MIRENE",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "415-360-3348"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.