Jeffrey M. Bloom M.D. Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JEFFREY M. BLOOM M.D. INC

Practice address

1318 Johnson Ave
San Luis Obispo, CA 93401-3314

Phone

(805) 541-2300

Fax

(805) 541-2301

NPI assigned

Nov 21, 2013

Organization subpart

No

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

Authorized official

Name

Jeffrey M Bloom, MDNPI 1154346377

Title

President

Phone

(805) 541-2300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey M Bloom, MD

  • Internal Medicine Physician
  • San Luis Obispo, CA
  • NPI 1154346377
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1384992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1457781841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013314",
            "telephone_number": "805-541-2300",
            "fax_number": "805-541-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013314",
            "telephone_number": "805-541-2300",
            "fax_number": "805-541-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY M. BLOOM M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-21",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-541-2300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Yu
• Vanessa Breann Jeffers, M.ED., BCBA
• Patrick John Jeffery
• Jeffrey B Mundorf, MD, Inc.
• Jeffrey Friedman, PHD, Psychologist, Inc
• David Allen Jeffrey, OTR
• Curby Dirk Jenkins, DO
• Melissa Jenkins
• Griffith Jennings
• Shannon Rive Jensen-Best, LMFT

• Internal Medicine Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.