Scott Bloom MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

162996 Issued in NY

Legal business name

SCOTT BLOOM MD PC

Practice address

99 Jericho Tpke
Suite 206
Jericho, NY 11753-1073

Phone

(516) 338-2900

Fax

(516) 338-2901

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Scott BloomNPI 1457432171

Title

Pres

Phone

(516) 338-2900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott Phillip Bloom

  • Family Medicine Physician
  • Jericho, NY
  • NPI 1457432171
  Medicare reassignment NPD Authorized official
• Alan A Mazurek, MD

  • Neurology Physician
  • Jericho, NY
  • NPI 1619083763
  NPD (past)
• Frieda Neuschotz, M.D.

  • Pediatrics Physician
  • Jericho, NY
  • NPI 1952453722
  NPD (past)
• Adam Jason Schneider, MD

  • Neurology Physician
  • Jericho, NY
  • NPI 1124137948
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685318400000",
    "number": "1295824530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 N BROADWAY STE 307",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532109",
            "telephone_number": "516-835-4092",
            "fax_number": "516-338-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 JERICHO TPKE",
            "address_2": "SUITE 206",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531073",
            "telephone_number": "516-338-2900",
            "fax_number": "516-338-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT BLOOM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-05-29",
        "certification_date": "2023-05-29",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "516-338-2900"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "162996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell L. Schare, PH.D.
• Adam Jason Schneider, MD
• Mark Jay Schnur, O.D.
• Stacy Brooke Schwartz
• Carina Scivolette, MHC-LP
• Ashley Sebastian
• Lauren Sena
• Kris Paul Shei
• Amit Mahesh Shelat, D.O.
• Philip Shen, D.C.

• Family Medicine Physician in Jericho, NY
• Providers in Jericho, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.