Individual provider Active NPI

Brad Reilly Fiske, MD

  • Internal Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1821791641
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A198557 Issued in CA
Practice address
1245 16TH St Ste 309
Santa Monica, CA 90404-1239
Phone
(310) 319-4377
NPI assigned
Mar 22, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A198557 CA Primary

Addresses

Primary practice location

1245 16TH St Ste 309
Santa Monica, CA 90404-1239

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90095-5631
Phone (310) 301-8836

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
I20260518002109 CA Practitioner - Internal Medicine 9133698368

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Vermont College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355248584, shared by 11 NPIs, 1,426 clinicians

Practice addresses (Care Compare)

1245 16TH St
Santa Monica, CA 90404-1239

1245 16TH St
Santa Monica, CA 90404-1240

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

Hospital & facility affiliations

National Provider Directory

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

Hospital & facility affiliations 1

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": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1821791641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900955631",
            "telephone_number": "310-301-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 16TH ST STE 309",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041239",
            "telephone_number": "310-319-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISKE",
        "first_name": "BRAD",
        "middle_name": "REILLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-22",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A198557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.