Individual provider Active NPI

Bryan P McDade

  • Speech-Language Assistant
  • Pacifica, CA
National Provider Identifier
1952404212
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
Practice address
80 Eureka SQ
Unit 217
Pacifica, CA 94044-2654
Phone
(650) 557-0885
Fax
(650) 477-1506
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X Primary
Developmental Therapist 222Q00000X
Physical Therapist 225100000X
Pediatric Physical Therapist 2251P0200X

Addresses

Primary practice location

80 Eureka SQ
Unit 217
Pacifica, CA 94044-2654

Mailing address

80 Eureka SQ
Unit 217
Pacifica, CA 94044-2654
Phone (650) 557-0885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1952404212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 EUREKA SQ",
            "address_2": "UNIT 217",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940442654",
            "telephone_number": "650-557-0885",
            "fax_number": "650-477-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 EUREKA SQ",
            "address_2": "UNIT 217",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940442654",
            "telephone_number": "650-557-0885",
            "fax_number": "650-477-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDADE",
        "first_name": "BRYAN",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacifica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.