Individual provider Active NPI

Matthew Brandon Bloom, M.D.

  • Surgical Critical Care Physician
  • San Jose, CA
National Provider Identifier
1477631844
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
A77610 Issued in CA
Practice address
2505 Samaritan Dr
#504
San Jose, CA 95124-4006
Phone
(408) 356-3753
NPI assigned
Nov 1, 2006
Last updated
Mar 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A77610 CA
Surgical Critical Care Physician 2086S0102X A77610 CA Primary

Addresses

Primary practice location

2505 Samaritan Dr
#504
San Jose, CA 95124-4006

Mailing address

2505 Samaritan Dr
#504
San Jose, CA 95124-4006
Phone (408) 356-3753

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050622000418 CA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 7214972165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Duke University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Quality
77.83
Promoting interoperability
98
Improvement activities
40
Cost
71.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A77610CAMDSurgery Physician
77610CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Interoperability endpoints

  • Direct secure messaging: mbloom170212@direct.cshs.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1477631844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 SAMARITAN DR",
            "address_2": "#504",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244006",
            "telephone_number": "408-356-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 SAMARITAN DR",
            "address_2": "#504",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244006",
            "telephone_number": "408-356-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "MATTHEW",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A77610",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "A77610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.