Individual provider Active NPI

Barbara Bloom, O.D.

  • Optometrist
  • Harrisburg, PA
National Provider Identifier
1407919558
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000267 Issued in PA
Practice address
4392 Sturbridge Dr
Harrisburg, PA 17110-3674
Phone
(717) 652-7710
Fax
(717) 541-9842
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000267 PA Primary

Addresses

Primary practice location

4392 Sturbridge Dr
Harrisburg, PA 17110-3674

Mailing address

4392 Sturbridge Dr
Harrisburg, PA 17110-3674
Phone (717) 652-7710

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20080415000633 PA Practitioner - Optometry 2961580014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optometry Associates, P.C.Group PAC ID 2466538467, 4 clinicians

Practice addresses (Care Compare)

4392 Sturbridge Dr
Suite 102
Harrisburg, PA 17110-3674
Phone (717) 652-7710

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000267PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometry Associates, P.C. Optometrist CurrentSince Aug 1, 1997 Accepting new patients
Bello Nurses LLC Past Accepting new patients

Locations

4240 Elmerton Ave
Harrisburg, PA 17109
Phone (717) 652-7710

4392 Sturbridge Dr
Harrisburg, PA 17110
Phone (717) 652-7710

4392 Sturbridge Dr
Ste 102
Harrisburg, PA 17110
Phone (717) 652-7710

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1407919558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4392 STURBRIDGE DR",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171103674",
            "telephone_number": "717-652-7710",
            "fax_number": "717-541-9842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4392 STURBRIDGE DR",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171103674",
            "telephone_number": "717-652-7710",
            "fax_number": "717-541-9842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "BARBARA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.