Adria Jay Bloom, MS, OTR/L
Individual provider Active NPI Occupational Therapist · New York, NY
NPI 1366725905 · NPPES record last updated May 16, 2025
Key facts
- NPI
- 1366725905
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 016228 (NY)
- Practice address
- 70 Park Ter E Apt 5D
New York, NY 10034-1416 - Phone
- (917) 960-9077
- NPI assigned
- Sep 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111102000676 | NY | Practitioner - Occupational Therapist in Private Practice | 4486827714 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46TR00530700 | NJ | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC | Current |
Accepting new patients | |
| New York Physical and Occupational Therapy Services, PLLC | Occupational Therapist | Current |
Accepting new patients |
Locations
2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925
3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080
147 W 35th St
Ste 407
New York, NY 10001
Phone (212) 842-0080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 46TR00530700 | NJ | |
| Occupational Therapist | 225X00000X | 016228 | NY | Yes |
Addresses
Primary practice location
70 Park Ter E Apt 5D
New York, NY 10034-1416
Mailing address
70 Park Ter E Apt 5D
New York, NY 10034-1416
Other providers in New York, NY
- Claire Elaine Bloodworth
- Bloom Medical Ny PLLC
- Bloom New York
- Bloom Psychotherapy Nyc LCSW PC
- Bloom Therapy
- Alana Bloom
- Amber Bloom
- Barbara Lynn Bloom
- Bradley Stephen Bloom
- Brandon Scott Bloom
All providers in New York, NY · Occupational Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.