Randy Bloom, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95012312 Issued in CA

Practice address

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221

Phone

(760) 773-2882

Fax

(760) 773-2680

NPI assigned

Jul 31, 2019

Last updated

Jan 23, 2020By 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 CA

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Eisenhower Medical CenterGroup PAC ID 5890689657, 462 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573
• Desert Regional Medical Center Hospital, Palm Springs, CA, CCN 050243

Merit-based Incentive Payment System (MIPS)

Final score

87.87 of 100Reported as group

Quality

85.37

Promoting interoperability

100

Improvement activities

40

Cost

74.18

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19187/brand/2/csg/1/fhir/r4

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.

• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  Medicare reassignment Care Compare group NPD
• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Palm Springs, CA
  • NPI 1598008658
  NPD
• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Cathedral City, CA
  • NPI 1629384615
  NPD
• Roland D Reinhart M D a Professional Corporation

  • Pain Medicine Physician
  • Palm Desert, CA
  • NPI 1285615955
  NPD (past)

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

• Desert Regional Medical Center, Inc.

  dba Desert Regional Medical Center

  • General Acute Care Hospital
  • Palm Springs, CA
  • NPI 1104856095
  Care Compare affiliation
• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  Care Compare affiliation

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1265086854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-773-2882",
            "fax_number": "760-773-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-773-2882",
            "fax_number": "760-773-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "RANDY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-31",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95012312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BLC Mirage Inn, L.P. (Brookdale Mirage Inn)
• Beverly Belle Blessing, FNP, PHD
• Jonathan William Blevins, M.D.
• Block Counseling, Family & Child Therapy Inc.
• Blood & Cancer Genetics Institute
• Richard Stevan Bloom, ASW
• Kimberly Ann Bluff, FNP
• Bobby S. Bhasker Rao MD Inc
• Katerina Isabella Bobluk, MD
• Ghassan E. Boghosian, DO

• Nurse Practitioner in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.