Brightside Medical of New Jersey, P.C.
Organization Active NPI Psychiatry Physician · San Francisco, CA
NPI 1811524754 · NPPES record last updated Nov 18, 2024
Key facts
- NPI
- 1811524754
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- BRIGHTSIDE MEDICAL OF NEW JERSEY, P.C.
- Practice address
- 5214F Diamond Heights Blvd # 345
San Francisco, CA 94131-2175 - Phone
- (415) 360-3348
- NPI assigned
- Mar 23, 2020
- Organization subpart
- No
Authorized official
- Name
- Daniel Karlin, MD
- Title
- President
- Phone
- (917) 699-6564
Practitioners 136
-
Andrea Caryn Bates, LCSW
-
Marie Cervellero Belanger, MSN, FNP- PMHNP- BC
-
Kareem Boles, PMHNP-BC
-
Shauntae Bowers, MS, LPC, LCAS
-
Melody Rose Chappel, LICSW
-
Jamica Cobbs, MSW, LCSW
-
Angelina De Santis, LMSW
-
Laura Duffy, MA, LPC, LCADC
-
Yvonne Ekama, NURSE PRACTITIONER
-
Sandra M. Gerardo, LCSW
-
Valeriya Ghette, NP
-
Shawn D Hackett, LCSW
-
Ashley Wayne Harris, LPC-A
-
Shean Kelly Harris, LPCA, LCASA
-
Letitia Titania Huger-Hill, LCMHCS
-
Hollianne Marie Ibarra, LCSWA
-
Carlton Jean, LCSW
-
Madeline Dolce March, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in NC, NJ, MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230517000302 | NC | Part B Supplier - Clinic/Group Practice | 5799141750 |
Receives reassigned benefits from 110 practitioners Practice locations: Raleigh, NC |
| O20230817001530 | NJ | Part B Supplier - Clinic/Group Practice | 5799141750 |
Receives reassigned benefits from 12 practitioners Practice locations: Pittsgrove, NJ; Oakland, NJ; Newark, NJ; Lakewood, NJ; Mount Laurel, NJ; Hoboken, NJ; Mount Holly, NJ; Branchburg, NJ… |
| O20230912000663 | MA | Part B Supplier - Clinic/Group Practice | 5799141750 |
Receives reassigned benefits from 3 practitioners Practice locations: Boston, MA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
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
Other providers in San Francisco, CA
- Elizabeth Tess Brigham
- Bright Hospice Care Inc
- Bright Path Therapists
- Brightside Health, Inc.
- Brightside Medical of Michigan PC
- Brightside Medical, P.a.
- Brightside Medical, P.C.
- Brightside Medical, P.C.
- Erin M Brightwell
- Andrew Brill
All providers in San Francisco, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.