Individual provider Active NPI

Cynthia R. Bloom, M.D.

  • Diagnostic Radiology Physician
  • Sarasota, FL
National Provider Identifier
1093774556
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME73265 Issued in FL
Practice address
1700 South Tamiami Trail
Sarasota, FL 34239
Phone
(941) 917-1668
Fax
(941) 917-4273
NPI assigned
Mar 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME73265 FL Primary

Addresses

Primary practice location

1700 South Tamiami Trail
Sarasota, FL 34239

Mailing address

2700 University Square Dr
Tampa, FL 33612-5513
Phone (813) 253-2721

Other identifiers 2

IdentifierTypeStateIssuer
41300OtherFLBLUE CROSS BLUE SHIELD OF FLORIDA
252222500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME73265FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Imaging LLC Diagnostic Radiology Past Accepting new patients
Radiology in Paradise LLC Diagnostic Radiology PastSince Jun 10, 2013 Accepting new patients
Tower Imaging LLC Diagnostic Radiology Past Accepting new patients
Lakewood-Manatee Radiology Consultants Past Accepting new patients
SMH Radiology Associates PA Diagnostic Radiology Past Accepting new patients
Axcess Diagnostics Bradenton LLC Diagnostic Radiology Past Accepting new patients
Team Radiology Physicians, PA Diagnostic Radiology Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1093774556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 UNIVERSITY SQUARE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125513",
            "telephone_number": "813-253-2721",
            "fax_number": "813-253-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SOUTH TAMIAMI TRAIL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34239",
            "telephone_number": "941-917-1668",
            "fax_number": "941-917-4273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "CYNTHIA",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME73265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
            "identifier": "41300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252222500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.