Scott Bloom

Primary specialty

OptometristTaxonomy code 152W00000X

License

4903603 Issued in MI

Practice address

1510 N Broadway St
Hastings, MI 49058-1007

Phone

(269) 945-2192

Fax

(269) 945-3937

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Scott Bloom OD PLC

  • Optometrist
  • Hastings, MI
  • NPI 1376732131
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236643200000",
    "number": "1407904188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 N BROADWAY ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490581007",
            "telephone_number": "269-945-2192",
            "fax_number": "269-945-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 N BROADWAY ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490581007",
            "telephone_number": "269-945-2192",
            "fax_number": "269-945-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2009-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4903603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2813638",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee Birchmeier
• Jill S Bishop, PSY
• Nichole Bivens-Heuss, RN
• Molly Faith Blackburn, LMSW
• Daniel Adam Blasch, PA-C
• Chadwick G Boehm, LMSW
• Alexis Bolo, BIHS
• Jacob Bolthouse
• Bosley Pharmacy No. 2 Inc
• Bosley Pharmacy No. 2 Inc

• Optometrist in Hastings, MI
• Providers in Hastings, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; 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.