Tanya Sarah Bloom, OD

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

8632 Issued in NY

Practice address

322 N Aurora St
Ithaca, NY 14850-4202

Phone

(607) 277-4749

NPI assigned

Jun 14, 2017

Last updated

May 2, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Whole Picture Health and Vision LLCGroup PAC ID 7719217553, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tanya.ayzikovich.1@18477.direct.athenahealth.com

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

• Whole Picture Health and Vision, LLC

  • Optometrist
  • Ithaca, NY
  • NPI 1609436542
  Medicare reassignment Care Compare group NPD Authorized official
• Larry B Wallace, OD

  • Vision Therapy Optometrist
  • Ithaca, NY
  • NPI 1073545059
  Medicare reassignment
• Access Physical Therapy & Wellness, LLC

  • Physical Therapist
  • New Fairfield, CT
  • NPI 1659819241
  NPD (past)
• Institute for Integrated Vision, LLC

  • Vision Therapy Optometrist
  • Stamford, CT
  • NPI 1982104535
  NPD (past)

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1144750035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 N AURORA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504202",
            "telephone_number": "607-277-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 N AURORA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504202",
            "telephone_number": "607-277-4749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6515 Main St Ste 8L",
            "address_purpose": "LOCATION",
            "city": "Trumbull",
            "state": "CT",
            "postal_code": "066111354",
            "country_code": "US",
            "telephone_number": "203-374-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "517 E 117th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100354409",
            "country_code": "US",
            "telephone_number": "212-896-5886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "444 Westport Ave",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CT",
            "postal_code": "068514481",
            "country_code": "US",
            "telephone_number": "203-840-1991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 Bedford St Ste 1M",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069055203",
            "country_code": "US",
            "telephone_number": "203-357-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 Post Rd",
            "address_purpose": "LOCATION",
            "city": "Southport",
            "state": "CT",
            "postal_code": "068901258",
            "country_code": "US",
            "telephone_number": "203-255-4005",
            "fax_number": "203-259-8748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "TANYA",
        "middle_name": "SARAH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008632",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3039",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CT",
            "license": "3039",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NY",
            "license": "8632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Bliss
• Althea Blodgett-Gallahan, RN, CNM
• Katrina Blomquist, PH.D.
• Joseph Blood, PAC
• Bloom Speech Therapy, PLLC
• Ariana Marie Blossom, LMT
• Donald G Bluh, MD
• William Frederic Blum
• Erynn Fraya Blume, SLP
• Aristopher Bo, RN

• Vision Therapy Optometrist in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Vision Therapy Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.