NPIMap

Organization Active NPI

Bloom Family Eye Surgeons LTD

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Dayton, OH
National Provider Identifier
1649342890
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
Legal business name
BLOOM FAMILY EYE SURGEONS LTD
Practice address
1 Childrens PLZ
Dayton, OH 45404-1898
Phone
(937) 641-3020
Fax
(937) 226-9605
NPI assigned
Nov 14, 2006
Last updated
Apr 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Authorized official

Name
Dr. Robert T Bloom, M.D.NPI 1578512893
Title
Owner
Phone
(937) 723-7772

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X Primary

Addresses

Primary practice location

1 Childrens PLZ
Dayton, OH 45404-1898

Mailing address

1 Childrens PLZ
Dayton, OH 45404-1898
Phone (937) 723-7772

Other identifiers 1

IdentifierTypeStateIssuer
2134452MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050918000031 OH Part B Supplier - Clinic/Group Practice 9335108554 Receives reassigned benefits from 8 practitioners
Practice locations: Dayton, OH

National Provider Directory

National Provider Directory
Tax ID family
Bloom Family Eye Surgeons2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1020 Woodman Dr
Dayton, OH 45432
Phone (937) 253-0606

1020 Woodman Dr
Ste 105
Dayton, OH 45432
Phone (937) 723-3248

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1649342890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041898",
            "telephone_number": "937-723-7772",
            "fax_number": "937-226-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041898",
            "telephone_number": "937-641-3020",
            "fax_number": "937-226-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM FAMILY EYE SURGEONS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-723-7772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2134452",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.