Individual provider Active NPI

Dennis A Bloomfield, MD

  • Specialist
  • Staten Island, NY
National Provider Identifier
1689667446
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
099669 Issued in NY
Practice address
1102 Victory Blvd
Staten Island, NY 10301-3622
Phone
(718) 442-5230
Fax
(718) 816-4927
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 099669 NY Primary

Addresses

Primary practice location

1102 Victory Blvd
Staten Island, NY 10301-3622

Mailing address

1102 Victory Blvd
Staten Island, NY 10301-3622
Phone (718) 442-5230

Other identifiers 2

IdentifierTypeStateIssuer
OS240OtherNYOXFORD
0057365OtherGHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
099669NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Richmond Cardio Pulmonary Care PC Past Accepting new patients
Angelic Care Center LLC Past Accepting new patients
Bard Cardiology Associates, PC Past Accepting new patients
Cynthia Wong, MD, PC PastSince Jan 23, 2012 Accepting new patients

Organizations & group practices 4

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": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1689667446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013622",
            "telephone_number": "718-442-5230",
            "fax_number": "718-816-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013622",
            "telephone_number": "718-442-5230",
            "fax_number": "718-816-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMFIELD",
        "first_name": "DENNIS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "099669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "OS240",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0057365",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.