Jason David Bloom, MD

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

MD432401 Issued in PA

Practice address

2 Town PL Ste 110
Bryn Mawr, PA 19010-3420

Phone

(610) 762-5666

Fax

(484) 380-3550

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Laser Surgery and Cosmetic Dermatology Centers Inc

  • Dermatology Physician
  • Ardmore, PA
  • NPI 1750666566

  Otolaryngology

  NPD
• Laser Surgery and Cosmetic Dermatology Centers Inc

  • Dermatology Physician
  • Bryn Mawr, PA
  • NPI 1104000512
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1184780108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TOWN PL STE 110",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103420",
            "telephone_number": "610-762-5666",
            "fax_number": "484-380-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TOWN PL STE 110",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103420",
            "telephone_number": "610-762-5666",
            "fax_number": "484-380-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "JASON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MT186824",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NY",
            "license": "256050",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "PA",
            "license": "MD432401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Lee Blake, PA-C
• Sarah Rachel Blatt, DO
• James R Bleiberg, PSY. D.
• Esther Skorr Bleier, MD
• Allison J Bloom, DO
• Brian Blumhof, M.D.
• Bmmsa Heart & Vascular Center of the Main Line
• Jenna Marie Bobadilla, PA
• Joseph-Gabriel F Bobadilla, DPM
• Lori Heather Bodenheimer, PA-C

• Otolaryngology/Facial Plastic Surgery Physician in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.