Individual provider Active NPI

Deena Bloom, AU.D

  • Assistive Technology Supplier Audiologist
  • Lawrence, NY
National Provider Identifier
1669222527
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistive Technology Supplier AudiologistTaxonomy code 231HA2500X
License
003244 Issued in NY
Practice address
290 Central Ave Ste 116
Lawrence, NY 11559-8507
Phone
(516) 239-6400
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistive Technology Supplier Audiologist 231HA2500X 003244 NY Primary

Addresses

Primary practice location

290 Central Ave Ste 116
Lawrence, NY 11559-8507

Mailing address

290 Central Ave Ste 116
Lawrence, NY 11559-8507
Phone (561) 239-6400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240524000619 NY Practitioner - Qualified Audiologist 4183066962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilks Hearing Center IncGroup PAC ID 8022908920, 2 clinicians

Practice addresses (Care Compare)

290 Central Ave
Suite 116
Lawrence, NY 11559-8507
Phone (516) 239-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wilks Hearing Center Inc Assistive Technology Supplier CurrentSince Apr 16, 2024 Accepting new patients

Locations

290 Central Ave
Ste 116
Lawrence, NY 11559
Phone (516) 239-6400

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": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1669222527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 CENTRAL AVE STE 116",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115598507",
            "telephone_number": "561-239-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CENTRAL AVE STE 116",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115598507",
            "telephone_number": "516-239-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "DEENA",
        "name_prefix": "Dr.",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "NY",
            "license": "003244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.