Braedan Bloom, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

30146 Issued in MD

Practice address

60 Market St Ste 206
Gaithersburg, MD 20878-6559

Phone

(301) 990-9599

NPI assigned

Jan 6, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proflex Physical Therapy of Maryland, LLCGroup PAC ID 7416244322, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Proflex Physical Therapy of Maryland, LLC.

  • Physical Medicine & Rehabilitation Physician
  • Waldorf, MD
  • NPI 1558714824

  DC, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Proflex Physical Thearpy of Maryland, LLC

  • Physical Medicine & Rehabilitation Physician
  • Stafford, VA
  • NPI 1700763851
  NPD

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1013726975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791217",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212791217",
            "telephone_number": "301-932-4786",
            "fax_number": "301-932-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MARKET ST STE 206",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208786559",
            "telephone_number": "301-990-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "BRAEDAN",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Blair
• Susan B. Blair, LCMFT, CCDP
• Kya Lee Bland
• Blissful Care Alliance, LLC.
• Linda L Bloch, LCSW-C
• Blue Star Integrative Health
• Peter Jan Bluvas Jr., M.D.
• Mary Fowaah Boateng, DNP, FNP
• Susan Boche-Diaz, LPN
• Bodytech Physical Medicine & Wellnes

• Physical Therapist in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.