Evan D Bloom, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

235804 Issued in MA

Practice address

1001 Potrero Ave
Suite 1E21
San Francisco, CA 94110-3518

Phone

(415) 206-8111

NPI assigned

Jun 16, 2008

Last updated

Mar 17, 2010By 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 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

State University of New York at Stony Brook, School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Redwood Medical Group IncGroup PAC ID 5496652703, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317
• Adventist Health St Helena Hospital, Saint Helena, CA, CCN 050013

Merit-based Incentive Payment System (MIPS)

Final score

90.74 of 100Reported as group

Quality

94

Promoting interoperability

92

Improvement activities

40

Cost

65.12

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

94.76

Improvement activities

40

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

• Pacific Redwood Medical Group Inc

  • Emergency Medicine Physician
  • Ukiah, CA
  • NPI 1033103676
  Medicare reassignment Care Compare group NPD
• Acute Medical Providers - Inpatient Inc.

  • Hospitalist Physician
  • Saint Helena, CA
  • NPI 1679080311
  NPD (past)
• Associated Physicians of Harvard Medical Faculty Physicians at Beth Is

  dba Associated Physicians of HMFP

  • Multi-Specialty Clinic/Center
  • Boston, MA
  • NPI 1861216038
  NPD (past)
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  dba Emergency Medicine - HMFP at BIDMC

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1316987993
  NPD (past)

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

• Adventist Health Clearlake Hospital Inc.

  dba Adventist Health Clear Lake

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Care Compare affiliation
• St. Helena Hospital

  dba Adventist Health St. Helena

  • General Acute Care Hospital
  • Saint Helena, CA
  • NPI 1720078082
  Care Compare affiliation

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1285894931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 OAK ST",
            "address_2": "APT 32",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025841",
            "telephone_number": "415-487-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "address_2": "SUITE 1E21",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "EVAN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "235804",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A108485",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Blood, ATC
• Tamara Lee Blood, MFTI
• Bloom Psychotherapy PC
• Allan I. Bloom, M.D.
• Christina Bloom, RN
• Howard R. Bloom, MD
• Jacqueline Bloom, LCSW, PH.D.
• Melissa Marie Bloom, PHD
• Michael Allen Bloom II, MS
• Stephanie R. Bloom, M. D.

• Emergency Medicine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.