Stuart M. Bloom, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G27742 Issued in CA

Practice address

2533 E Main St
Ventura, CA 93003-2618

Phone

(805) 652-2244

Fax

(805) 652-0469

NPI assigned

Oct 17, 2006

Last updated

Sep 25, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1578643060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2533 E MAIN ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032618",
            "telephone_number": "805-652-2244",
            "fax_number": "805-652-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2533 E MAIN ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032618",
            "telephone_number": "805-652-2244",
            "fax_number": "805-652-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "STUART",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G27742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G27742",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kurt Blickenstaff, M.D.
• David Blitzer, M.D.
• Robert Louis Blomquist, RPH
• Natasha Blonsky, PA-C
• Matthew Lee Bloom, DO
• Everett Michael Blough
• Blue Lotus Counseling
• Richard Alan Blue, OD
• Leah Michelle Blumenthal, AMFT
• Laura Ann Boatman

• Family Medicine Physician in Ventura, CA
• Providers in Ventura, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.