Cody Philip Blom, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3974 Issued in MT

Practice address

1221 Dewey Blvd
Butte, MT 59701-3413

Phone

(406) 494-2222

NPI assigned

Feb 23, 2021

Last updated

Feb 23, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

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

Pacific University - College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vital Vision PLLCGroup PAC ID 0941622112, 3 clinicians

Serendipity EyecareGroup PAC ID 6406080787, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serendipity Eyecare

  dba 20Twenty Eyecare

  • Optometrist
  • Bozeman, MT
  • NPI 1093152266
  Medicare reassignment Care Compare group NPD
• Vital Vision PLLC

  • Optometrist
  • Bozeman, MT
  • NPI 1962024125
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1265026033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 TEMPEST CT",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186109",
            "telephone_number": "406-498-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 DEWEY BLVD",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597013413",
            "telephone_number": "406-494-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 W Kagy Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597156055",
            "country_code": "US",
            "telephone_number": "406-404-1375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "280 W Kagy Blvd",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597156056",
            "country_code": "US",
            "telephone_number": "406-522-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOM",
        "first_name": "CODY",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "3974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ladonna Dee Black, LCPC
• Karen Blackbird, LCSW
• Pamela Jane Blando, ATC
• Nick Blavatsky, MD
• Laura Beth Block, M.ED., LCPC
• Blue Mountain Counseling
• Bodine Medical LLC
• Jonathan A Bodine, D.O.
• Kerry Bohlken, APRN, FNP-C
• Timothy Bolewicz, OTR

• Optometrist in Butte, MT
• Providers in Butte, MT by specialty
• Optometrist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.
• 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.