Active NPI
Richard Stevan Bloom, ASW
- Clinical Social Worker
- Rancho Mirage, CA
National Provider Identifier
1548396146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 26170 CSW
- Practice address
- 39700 Bob Hope Dr
Suite 216
Rancho Mirage, CA 92270-3267 - Phone
- (760) 837-8767
- Fax
- (760) 837-8806
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW15170 | CA | |
| Clinical Social Worker | 1041C0700X | 26170 CSW | CA | Primary |
Addresses
Primary practice location
39700 Bob Hope Dr
Suite 216
Rancho Mirage, CA 92270-3267
Mailing address
39700 Bob Hope Dr
Suite 216
Rancho Mirage, CA 92270-3267
Phone (760) 837-8767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26170 CSW | CA | MD | Clinical Social Worker |
| ASW15170 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eisenhower Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Rancho Mirage, CA
- NPI 1013981554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456358400000",
"number": "1548396146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39700 BOB HOPE DR",
"address_2": "SUITE 216",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922703267",
"telephone_number": "760-837-8767",
"fax_number": "760-837-8806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39700 BOB HOPE DR",
"address_2": "SUITE 216",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922703267",
"telephone_number": "760-837-8767",
"fax_number": "760-837-8806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOM",
"first_name": "RICHARD",
"middle_name": "STEVAN",
"credential": "ASW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2016-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW15170",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "26170 CSW",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rancho Mirage, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.