Jessica J. Bloom, MD
Individual provider Active NPI Family Medicine Physician · Bellingham, WA
NPI 1437199643 · NPPES record last updated Aug 1, 2012
Key facts
- NPI
- 1437199643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD00044811 (WA)
- Practice address
- 3500 Orchard PL
Bellingham, WA 98225-1749 - Phone
- (360) 671-3900
- Fax
- (360) 647-0882
- NPI assigned
- Jun 7, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Minnesota Medical School, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Family Care Network, PLLC
Practice addresses (Care Compare)
3500 Orchard PL
Bellingham, WA 98225-1749
Phone (360) 671-3900
Hospital & facility affiliations
- Peacehealth St Joseph Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050601000235 | WA | Practitioner - Family Practice | 8325080229 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Care Network PLLC | Family Medicine | Current |
Accepting new patients |
| Family Care Network PLLC | Family Medicine | Current | Accepting new patients |
| Family Care Network PLLC | Family Medicine | Current |
Accepting new patients |
| Peacehealth | Past | Accepting new patients | |
| Family Care Network PLLC | Family Medicine | Past |
Accepting new patients |
Locations
1610 Grover St
Ste D1
Lynden, WA 98264
Phone (360) 312-3785
Interoperability endpoints
- jbloom19457@direct.fcn.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00044811 | WA | Yes |
Addresses
Primary practice location
3500 Orchard PL
Bellingham, WA 98225-1749
Mailing address
709 W Orchard Dr
Suite 4
Bellingham, WA 98225-1766
Phone (360) 318-8800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3976BL | Other | WA | REGENCE BLUESHIELD |
| 423898075 | Other | WA | GROUP HEALTH COOPERATIVE |
| 0196371 | Other | WA | LABOR & INDUSTRIES (REG) |
| P00235723 | Other | WA | RAILROAD MEDICARE |
| 8423782 | Medicaid | WA | |
| 8905718 | Other | WA | LABOR & INDUSTRIES (CV) |
NPI Registry JSON
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343779200000",
"number": "1437199643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 W ORCHARD DR",
"address_2": "SUITE 4",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251766",
"telephone_number": "360-318-8800",
"fax_number": "360-318-1085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 ORCHARD PL",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251749",
"telephone_number": "360-671-3900",
"fax_number": "360-647-0882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOM",
"first_name": "JESSICA",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-07",
"last_updated": "2012-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00044811",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUESHIELD",
"identifier": "3976BL",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH COOPERATIVE",
"identifier": "423898075",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES (REG)",
"identifier": "0196371",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00235723",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8423782",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES (CV)",
"identifier": "8905718",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
- Hailee Elizabeth Blomquist
- Jake Blondheim
- Bloom Therapy & Wellness
- Bloom Womens Healthcare PLLC
- Edward W. Bloom
- Steven M. Bloom
- Jared Julius Blum
- Shaun Blum
- Wendy Blum
- Julia Blunt
All providers in Bellingham, WA · Family Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.