MR. BRIAN MACK FNP-C
NPI 1063979128
Nurse Practitioner in San Francisco, CA

Q: What is Brian Mack's NPI number?

The NPI number for Brian Mack is 1063979128. It was assigned to this individual provider in the NPPES registry on February 25, 2019.

Q: What is Brian Mack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Brian Mack was last updated on December 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 25, 2019PECOS Enrolled

655 MONTGOMERY ST STE 810, SAN FRANCISCO, CA 94111(844) 847-8216(415) 520-9150 Get Directions Write a Review

NPPES record last updated: December 19, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 23, 2023, Sep 20, 2022, Mar 3, 2022 and 2 more (5 updates tracked since 2019).

On this page

About Mr. Brian Mack Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BRIAN MACK FNP-C (NPI 1063979128) is an individual nurse practitioner in San Francisco, California, licensed in North Carolina (5011498) and active in the NPI registry since February 2019. He is enrolled in Medicare PECOS and maintains a secondary practice location in Greensboro.

NPPES Registry Identity

NPI1063979128

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameMR. BRIAN MACKCredential: FNP-C

Location Address655 MONTGOMERY ST STE 810San Francisco, CA 94111-2677

Mailing Address5001 Quincemoor CtGreensboro, NC 27407-7789 · (336) 840-8338

Phone(844) 847-8216

Fax(415) 520-9150

Sole ProprietorNo

Enumeration DateFebruary 25, 2019

Last NPPES UpdateDecember 19, 20235 updates tracked since enumeration

NPPES CertifiedDecember 19, 2023

✔ NPI 1063979128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NC · 5011498

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License 5011498 (NC)

Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 5011498 (NC)

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License 5011498 (NC)

655 MONTGOMERY ST STE 810, San Francisco, CA 94111

Open in Google Maps ↗

Secondary Practice Location 1

Location 15001 Quincemoor CtGreensboro, NC 27407-7789 · Phone (336) 840-8338

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Brian Mack Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Brian Mack reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Virta Medical P.C.

Same address

Internal Medicine

655 MONTGOMERY ST STE 810
San Francisco, CA 94111

Reassigned Medicare billing, Alaska, Alabama, Arkansas, Arizona, California, Colorado, Connecticut, District of Columbia, Delaware, Florida, Georgia, Hawaii, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, Mississippi, Montana, North Carolina, North Dakota, New Hampshire, New Jersey, New Mexico, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Vermont, Wisconsin, West Virginia and Wyoming enrollments
Medicare enrollment name: Virta Medical PC
4 clinicians in this Medicare group

NPI 1093225138 (844) 847-8216

Moses Cone Medical Services, Inc.

2,326 mi

Family Medicine

401 W DECATUR ST
Madison, NC 27025

Reassigned Medicare billing, North Carolina enrollment
351 clinicians in this Medicare group

NPI 1629376363 (336) 548-9618

The Moses H. Cone Memorial Hospital Operating Corporation

2,339 mi

Internal Medicine

509-E NORTH ELAM AVENUE, 3RD FLOOR
Greensboro, NC 27403

Reassigned Medicare billing, North Carolina enrollment
835 clinicians in this Medicare group

NPI 1013265909 (336) 832-1970

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94111 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 14

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

10 suppliers36 claims36 services$34.60 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

9 suppliers29 claims29 services$71.67 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

8 suppliers24 claims65 services$31.31 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

5 suppliers11 claims66 services$17.52 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

9 suppliers22 claims22 services$48.71 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

13 suppliers29 claims29 services$16.10 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ALEXANDRA CRISTINA VILLASANTE FRICKE MD

Internal Medicine (Endocrinology, Diabetes & Metabolism)