Ryan Bloom, MD

Key facts

NPI

1194575209

Entity type

Individual (NPI type 1)

Primary specialty

Student in an Organized Health Care Education/Training Program 390200000X

Practice address

102 Irving St NW
Washington, DC 20010-2921

Phone

(202) 877-1587

NPI assigned

Mar 25, 2024

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Medicine

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 25, 2024.

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1194575209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102921",
            "telephone_number": "202-877-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

• Bloom OB GYN, LLC
• Sally Bloom-Feshbach, PH.D.
• Adam Bloom, LCPC, LPC, NCC, MAC
• Cynthia Bloom
• Miriam D Bloom, MD
• Melissa J Bloomer, M.A., CCC-SLP
• Joanna Bloomfield
• Kevin Alexander Bloomfield II
• Oluwaseun Blose
• Blossom Dentistry PLLC

All providers in Washington, DC · Student in an Organized Health Care Education/Training Program in District of Columbia