Jeffrey Howard Bloom, D.O.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

20A6397 Issued in CA

Practice address

20311 SW Acacia St
Suite 100
Newport Beach, CA 92660-1733

Phone

(949) 263-1242

Fax

(949) 263-1280

NPI assigned

Jul 27, 2005

Sex

Male

Sole proprietor

No

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

Specialty

Family PracticeAlso: Sports Medicine

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hoag Home Health Home health agency, Newport Beach, CA, CCN 557412
• Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Jeffrey Bloom D.O. Inc, Dba Back Bay Medical

  • Sports Medicine (Family Medicine) Physician
  • Newport Beach, CA
  • NPI 1538405220
  NPD (past) Authorized official
• Pacific Oaks Medical Group & Subsidiary

  • Podiatrist
  • Costa Mesa, CA
  • NPI 1639669229
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hoag Home Health LLC

  • Home Health Agency
  • Newport Beach, CA
  • NPI 1174192892
  Care Compare affiliation
• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  Care Compare affiliation

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669472148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 PALOMA DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926486833",
            "telephone_number": "714-420-6620",
            "fax_number": "949-263-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20311 SW ACACIA ST",
            "address_2": "SUITE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601733",
            "telephone_number": "949-263-1242",
            "fax_number": "949-263-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "JEFFREY",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A6397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "20A6397",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Michael Blatt, MD
• Emily Blenker, DC
• Katherine Sherman Blevins, M.D., PH.D.
• Barton J Blinder, M.D.
• Bloom Counseling and Consulting, Inc
• Blue Harbor Dermatology Inc
• Michelle Blue
• Anthony Thomas Bober, M.S.,M.F.T.
• Sarah Bobich, PA-C
• Hillel Bocian, MD

• Sports Medicine (Family Medicine) Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Sports Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• 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.