Individual provider Active NPI

Brian James Secemsky, M.D.

  • Internal Medicine Physician
  • San Francisco, CA
National Provider Identifier
1790044519
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
128809 Issued in CA
Practice address
501 2ND St Ste 415
San Francisco, CA 94107-4132
Phone
(415) 529-4567
Fax
(415) 291-0489
NPI assigned
May 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 128809 CA Primary

Addresses

Primary practice location

501 2ND St Ste 415
San Francisco, CA 94107-4132

Mailing address

501 2ND St Ste 415
San Francisco, CA 94107-4132
Phone (415) 529-4567

Other practice location 1

4 Embarcadero Ctr
Lobby Level
San Francisco, CA 94111-4106
Phone (415) 529-4566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Sep 11, 2024 through Sep 11, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
128809CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1790044519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 2ND ST STE 415",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941074132",
            "telephone_number": "415-529-4567",
            "fax_number": "415-291-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 2ND ST STE 415",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941074132",
            "telephone_number": "415-529-4567",
            "fax_number": "415-291-0489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Embarcadero Ctr",
            "address_2": "Lobby Level",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941114106",
            "country_code": "US",
            "telephone_number": "415-529-4566",
            "fax_number": "415-291-0489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SECEMSKY",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-14",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "128809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.