Luna L Blossom

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0225811 Issued in NY

Practice address

1560 Mayflower Ave
Bronx, NY 10461-5400

Phone

(718) 948-1900

NPI assigned

Jun 5, 2018

Last updated

Jul 24, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Olympia School District

  • Local Education Agency (LEA)
  • Olympia, WA
  • NPI 1922024678
  NPD (past)

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1689166621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W 171ST ST APT 2K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323108",
            "telephone_number": "360-688-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 MAYFLOWER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104615400",
            "telephone_number": "718-948-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 Legion Way SE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985011697",
            "country_code": "US",
            "telephone_number": "360-596-7530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOSSOM",
        "first_name": "LUNA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "0225811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Bloom
• Kenneth Edward Bloom, M.D.
• Rita Marie Bloom
• Diane E Bloomfield, MD
• Noah Aaron Bloomgarden, M.D.
• Blossoming Scolars, Inc (Blossoming Scholars, Inc)
• Stacey Blot
• Cherron Blount
• Blu-White Associated Transportation Service Inc
• Matthew Richard Bludorn, D.O.

• Occupational Therapist in Bronx, NY
• Providers in Bronx, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.