Ellie P Goldbloom, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0053968 Issued in MD

Practice address

21 Crossroads Dr
Suite 400
Owings Mills, MD 21117-5441

Phone

(410) 998-9100

Fax

(410) 998-9104

NPI assigned

Dec 15, 2005

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Internal Medicine

Education

University of Maryland School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Partnermd Maryland PCGroup PAC ID 0547492100, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Homecare Maryland, LLC Home health agency, Owings Mills, MD, CCN 217107
• Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012
• Johns Hopkins Hospital, the Hospital, Baltimore, MD, CCN 210009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ellie.goldbloom.1@2180.direct.athenahealth.com

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.

• Partnermd Maryland PC

  • Family Medicine Physician
  • Owings Mills, MD
  • NPI 1952739500

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Homecare Maryland, LLC

  • Home Health Agency
  • Owings Mills, MD
  • NPI 1144400805
  Care Compare affiliation
• Sinai Hospital of Baltimore, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1285672204
  Care Compare affiliation
• Sinai Hospital of Baltimore, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1487325874
  Care Compare affiliation
• The Johns Hopkins Hospital

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1578597993
  Care Compare affiliation

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271376000000",
    "number": "1437135092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CROSSROADS DR",
            "address_2": "SUITE 400",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175441",
            "telephone_number": "410-998-9100",
            "fax_number": "410-998-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CROSSROADS DR",
            "address_2": "SUITE 400",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175441",
            "telephone_number": "410-998-9100",
            "fax_number": "410-998-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBLOOM",
        "first_name": "ELLIE",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2010-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0053968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "654003100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE PIN",
            "identifier": "P00759902",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE GROUP PIN",
            "identifier": "C31152",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Elise Goggin, PT, DPT
• Goldb
• Jessica Bess Goldberg, BCBA, LBA
• Julian Robert Goldberg, M.D.
• Rachel Tova Goldberg, BCBA, LBA
• Liba Eshter Goldblum, M.D.
• Golden Counseling Services, LLC
• Golden Times Care LLC
• Bracha Goldfeiz
• Esther Goldfeiz

• Internal Medicine Physician in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; 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.