Individual provider Active NPI

Brandy Lee Bloom, ARNP

  • Family Nurse Practitioner
  • Punxsutawney, PA
National Provider Identifier
1184142440
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP021533 Issued in PA
Practice address
81 Hillcrest Dr
Punxsutawney, PA 15767-2605
Phone
(814) 938-2064
NPI assigned
Sep 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ARNP9313168 FL
Family Nurse Practitioner 363LF0000X SP021533 PA Primary

Addresses

Primary practice location

81 Hillcrest Dr
Punxsutawney, PA 15767-2605

Mailing address

81 Hillcrest Dr
Punxsutawney, PA 15767-2605
Phone (814) 938-2064

Other practice location 1

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone (850) 862-7607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200707001862 PA Practitioner - Nurse Practitioner 5294091856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Punxsutawney Area Hospital IncGroup PAC ID 3375517147, 33 clinicians

Practice addresses (Care Compare)

81 Hillcrest Dr
Punxsutawney, PA 15767-2605

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP021533PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Punxsutawney Area Hospital Inc Family CurrentSince May 1, 2023 Accepting new patients
Punxsutawney Area Hospital Inc Current Accepting new patients
Punxsutawney Area Hospital Inc. CurrentSince May 1, 2023 Accepting new patients
Indiana Healthcare Physician Services Inc Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Indiana Healthcare Physician Services, Inc CurrentSince Aug 1, 2022 Accepting new patients

Locations

640 Kolter Dr
Indiana, PA 15701
Phone (724) 357-7196

879 Hospital Rd
Indiana, PA 15701
Phone (724) 349-3031

81 Hillcrest Dr
Ste 200
Punxsutawney, PA 15767

81 Hillcrest Dr
Ste 2200
Punxsutawney, PA 15767
Phone (814) 938-1451

81 Hillcrest Dr
Ste 100
Punxsutawney, PA 15767
Phone (814) 938-7045

81 Hillcrest Dr
Punxsutawney, PA 15767
Phone (814) 938-1800

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1184142440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HILLCREST DR",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157672605",
            "telephone_number": "814-938-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HILLCREST DR",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157672605",
            "telephone_number": "814-938-2064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Mar Walt Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325476708",
            "country_code": "US",
            "telephone_number": "850-862-7607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "BRANDY",
        "middle_name": "LEE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ARNP9313168",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP021533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Punxsutawney, PA

Sources for this page

Verify at the official NPI Registry.