Individual provider Active NPI

Jessica Bloom-Foster, MD

  • Family Medicine Physician
  • Bangor, ME
National Provider Identifier
1396734182
Registry record updated Jan 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
018155 Issued in ME
Practice address
895 Union St
Suite 12
Bangor, ME 04401-3053
Phone
(207) 973-7979
Fax
(207) 947-9579
NPI assigned
Oct 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 018155 ME Primary

Addresses

Primary practice location

895 Union St
Suite 12
Bangor, ME 04401-3053

Mailing address

43 Whiting Hill Rd
Suite 300
Brewer, ME 04412-1005
Phone (207) 973-5035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20090617000139 ME Practitioner - Family Practice 3678532967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Perelman School of Med at the University of Pennsylvania, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

895 Union St
Suite 12
Bangor, ME 04401-3054
Phone (207) 973-7979

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
222450MAMDClinical Social Worker
018155MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince May 27, 2009 Accepting new patients
Eastern Maine Medical Center CurrentSince May 27, 2009 Accepting new patients
Eastern Iowa Health Center Family Medicine Past Accepting new patients

Locations

895 Union St
Ste 12
Bangor, ME 04401
Phone (207) 973-7973

489 State St
Bangor, ME 04401
Phone (207) 973-8837

489 State St
Ste A
Bangor, ME 04401

43 Whiting Hill Rd
Ste 300
Brewer, ME 04412
Phone (207) 973-5000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263081600000",
    "number": "1396734182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD",
            "address_2": "SUITE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121005",
            "telephone_number": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 UNION ST",
            "address_2": "SUITE 12",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013053",
            "telephone_number": "207-973-7979",
            "fax_number": "207-947-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM-FOSTER",
        "first_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2010-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "018155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.