NPIMap

Organization Active NPI

Brightline Medical Associates, PA

  • Adolescent and Children Mental Health Clinic/Center
  • San Mateo, CA
National Provider Identifier
1831783638
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
BRIGHTLINE MEDICAL ASSOCIATES, PA
Practice address
400 Concar Dr
San Mateo, CA 94402-2681
Phone
(888) 224-7332
NPI assigned
Feb 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Barrett Dwyer
Title
Chief Financial Officer
Phone
(888) 224-7332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

400 Concar Dr
San Mateo, CA 94402-2681

Mailing address

400 Concar Dr
San Mateo, CA 94402-2681
Phone (888) 224-7332

Other names 1

  • Brightline Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brightline2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1831783638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CONCAR DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022681",
            "telephone_number": "888-224-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CONCAR DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022681",
            "telephone_number": "888-224-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTLINE MEDICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-23",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "BARRETT",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "888-224-7332"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brightline",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brightline",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.