NPIMap

Organization Active NPI

Brightside Medical, P.a.

  • Psychiatry Physician
  • San Francisco, CA
National Provider Identifier
1609335660
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.A.
Practice address
5214F Diamond Heights Blvd # 345
San Francisco, CA 94131-2175
Phone
(415) 360-3348
NPI assigned
Mar 18, 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
Administrator
Phone
(415) 360-3348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 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 IL, CO, AZ, NH, KS, ID, WI, MN, IA9 enrollments

Enrollment records 9

Enrollment IDStateProvider typePAC IDDetails
O20230331000963 IL Part B Supplier - Clinic/Group Practice 3678948809 Receives reassigned benefits from 48 practitioners
Practice locations: Chicago, IL
O20230419000008 CO Part B Supplier - Clinic/Group Practice 3678948809 Receives reassigned benefits from 16 practitioners
Practice locations: Denver, CO
O20230425001219 AZ Part B Supplier - Clinic/Group Practice 3678948809 Receives reassigned benefits from 33 practitioners
Practice locations: Phoenix, AZ
O20230509002124 NH Part B Supplier - Clinic/Group Practice 3678948809 Receives reassigned benefits from 5 practitioners
Practice locations: Manchester, NH
O20230509002796 KS Part B Supplier - Clinic/Group Practice 3678948809 Receives reassigned benefits from 8 practitioners
Practice locations: Wichita, KS
O20230524002881 ID Part B Supplier - Clinic/Group Practice 3678948809 Receives reassigned benefits from 1 practitioner
Practice locations: Boise, ID
O20230525002664 WI Part B Supplier - Clinic/Group Practice 3678948809 Receives reassigned benefits from 17 practitioners
Practice locations: Milwaukee, WI
O20230818003438 MN Part B Supplier - Clinic/Group Practice 3678948809 Receives reassigned benefits from 12 practitioners
Practice locations: Saint Paul, MN
O20230913001057 IA Part B Supplier - Clinic/Group Practice 3678948809 Receives reassigned benefits from 3 practitioners
Practice locations: Ames, IA

National Provider Directory

National Provider Directory

Locations

1333 Buckeye Ave
Ames, IA 50010

2136 Ford Pkwy
#5608
Saint Paul, MN 55116

Practitioners & affiliated clinicians

Practitioners 154

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 154

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1609335660",
    "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTSIDE MEDICAL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-18",
        "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": "ADMINISTRATOR",
        "authorized_official_telephone_number": "415-360-3348"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "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.