Amy Bloom, PT, DPT
Individual provider Active NPI Physical Therapist · Palmer, AK
NPI 1215487533 · NPPES record last updated Jul 20, 2022
Key facts
- NPI
- 1215487533
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 120733 (AK)
- Practice address
- 1734 Prospect Dr
Palmer, AK 99645-9655 - Phone
- (252) 635-1788
- NPI assigned
- Oct 11, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Arctic Chiropractic East Mat-Su LLC
Practice addresses (Care Compare)
1734 N Prospect Dr
Palmer, AK 99645-9655
Phone (907) 746-7842
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC, AK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161214001367 | NC | Practitioner - Physical Therapist in Private Practice | 9234419946 | Reassigns benefits to 1 organization |
| I20190725001715 | AK | Practitioner - Physical Therapist in Private Practice | 9234419946 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09597R | LA | MD | Internal Medicine Physician |
| 120733 | AK | MD | Physical Therapist |
| 16655 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Orthopaedics & Spinal Surgery PA | Physical Therapist | Current |
Accepting new patients |
| Arctic Chiropractic East Mat-Su LLC | Physical Therapist | Current |
Accepting new patients |
| Arctic Medical Center Matsu | Current |
Accepting new patients | |
| Coastal Orthopaedics and Spinal Surgery, PA | Physical Therapist | Past |
Accepting new patients |
Locations
1150 S Colony Way
Ste 3
Palmer, AK 99645
612B McCarthy Blvd
New Bern, NC 28562
Phone (252) 635-1788
612 McCarthy Blvd
#B
New Bern, NC 28562
Phone (252) 635-1788
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 16655 | NC | |
| Physical Therapist | 225100000X | 120733 | AK | Yes |
Addresses
Primary practice location
1734 Prospect Dr
Palmer, AK 99645-9655
Mailing address
1734 Prospect Dr
Palmer, AK 99645-9655
Other providers in Palmer, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.