Individual provider Active NPI

Bryan Thomas Bourdeau, MD

  • Internal Medicine Physician
  • San Francisco, CA
National Provider Identifier
1750876991
Registry record updated May 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A202521 Issued in CA
Practice address
521 Parnassus Ave
San Francisco, CA 94143-2206
Phone
(415) 476-1000
NPI assigned
Jun 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 276390 MA
Internal Medicine Physician 207R00000X A202521 CA Primary
Internal Medicine Physician 207R00000X 286471 MA

Addresses

Primary practice location

521 Parnassus Ave
San Francisco, CA 94143-2206

Mailing address

330 Brookline Ave
Boston, MA 02215-5491
Phone (617) 667-7000

Other practice location 1

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-4100

Other practice location 2

330 Brookline Ave
Boston, MA 02215-5491
Phone (617) 667-7000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250513001731 CA Practitioner - Internal MedicinePractitioner - Hospitalist 7517295991 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1701 Divisadero St
San Francisco, CA 94115-3011
Phone (415) 476-4029

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-4029

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A202521CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services Internal Medicine CurrentSince May 4, 2025 Accepting new patients
Regents of the University of California Internal Medicine CurrentSince May 4, 2025 Accepting new patients
University of California San Francisco CurrentSince May 4, 2025 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince May 4, 2025 Accepting new patients
University of California San Francisco CurrentSince May 4, 2025 Accepting new patients
Regents of the University of California Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

521 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9035

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

Interoperability endpoints

  • Direct secure messaging: bbourdeau436591@direct-ucsfmedicalcenter.org

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746316800000",
    "number": "1750876991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-667-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432206",
            "telephone_number": "415-476-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142696",
            "country_code": "US",
            "telephone_number": "617-724-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155491",
            "country_code": "US",
            "telephone_number": "617-667-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURDEAU",
        "first_name": "BRYAN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-29",
        "last_updated": "2025-05-04",
        "certification_date": "2025-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "276390",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A202521",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "286471",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.