Dennis Blom, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

196361 Issued in NY

Practice address

2202 Genesee St
Utica, NY 13502

Phone

(315) 732-0349

Fax

(315) 732-0309

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

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 and National Provider Directory roles.

• Vohra Wound Physicians of Ny, PLLC

  • Family Medicine Physician
  • New York, NY
  • NPI 1447527320

  NY

  Medicare reassignment Care Compare group NPD
• University General Surgeons, Inc.

  • Surgery Physician
  • Indianapolis, IN
  • NPI 1811019847

  Surgery

  NPD (past)
• University Surgeons, Inc.

  • Surgery Physician
  • Indianapolis, IN
  • NPI 1316966229

  Surgery

  NPD (past)

Specialty

General Surgery

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vohra Wound Physicians of Ny PLLC 35 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1376501940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13502",
            "telephone_number": "315-732-0349",
            "fax_number": "315-732-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13502",
            "telephone_number": "315-732-0349",
            "fax_number": "315-732-0309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Sawgrass Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146204651",
            "country_code": "US",
            "telephone_number": "585-242-1380",
            "fax_number": "585-244-2481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOM",
        "first_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "1060363A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "196361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03107559",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Jo Black
• Ashley A. Blanchard, NP
• Lisa Blanchfield, PSYD
• Brianna Blancovich, BCBA
• Susan M Blatt, M.D.
• Jaime Michelle Blum, FNP
• Bobs Pharmacy LLC
• Bobs Pharmacy LLC
• Bodywise Pure Pilates, LLC
• Deanna Boehlert

• All providers in Utica, NY
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.