Individual provider Active NPI

Richard Stevan Bloom, ASW

  • Clinical Social Worker
  • Rancho Mirage, CA
National Provider Identifier
1548396146
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26170 CSW Issued in CA
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

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
26170 CSWCAMDClinical Social Worker
ASW15170CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.