Individual provider Active NPI

Randall Adam Bloch, MD

  • Surgery Physician
  • Boston, MA
National Provider Identifier
1497329296
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
289646 Issued in MA
Practice address
736 Cambridge St
Boston, MA 02135-2907
Phone
(617) 789-2990
NPI assigned
May 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 289646 MA Primary

Addresses

Primary practice location

736 Cambridge St
Boston, MA 02135-2907

Mailing address

60 Brainerd Rd Unit 403
Boston, MA 02134-4582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210809000960 MA Order and Referring Only - General SurgeryPractitioner - General Surgery 9638573975

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: randall.bloch.1@2017.direct.athenahealth.com
  • Direct secure messaging: rbloch259813@direct.bmc.masshiway.net

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1497329296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 BRAINERD RD UNIT 403",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021344582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCH",
        "first_name": "RANDALL",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2022-08-12",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "289646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.