Tracy Roy Bloom II, NURSE PRACTITIONER

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

14057 Issued in CA

Practice address

1705 Georgia St
Napa, CA 94559-1621

Phone

(707) 738-3637

NPI assigned

Oct 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Tracy Cassandra Schneider Former name

Electronic endpoints 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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence at Home With Compassus Home Health, Napa Valley Home health agency, Napa, CA, CCN 057659
• Providence Queen of the Valley Medical Center Hospital, Napa, CA, CCN 050009

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Providence Medical Foundation

  • Obstetrics & Gynecology Physician
  • Napa, CA
  • NPI 1205131950
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• St. Joseph Health Northern California, LLC

  • Rehabilitation Hospital Unit
  • Napa, CA
  • NPI 1609947282
  NPD (past)

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

• CP Napa Valley N-Ca HH, LLC

  • Home Health Agency
  • Napa, CA
  • NPI 1720800915
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Napa, CA
  • NPI 1013080084
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Napa, CA
  • NPI 1235218785
  Care Compare affiliation

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1699858357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 GEORGIA ST",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945591621",
            "telephone_number": "707-265-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 GEORGIA ST",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945591621",
            "telephone_number": "707-738-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "TRACY",
        "middle_name": "ROY",
        "name_prefix": "Mrs.",
        "name_suffix": "II",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "616687",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "14057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CA131881",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbloom1647975@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1100 Trancas St Ste 256",
            "city": "Napa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945582921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "SCHNEIDER",
            "middle_name": "CASSANDRA",
            "prefix": "MS.",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Blanchard
• Elijah Blanco
• Daniel Ben Bleman, M.D.
• Denise M. Bleuel, L.C.S.W.
• Jennel Blevins
• Charlene Blount
• Austin William Blum, MD, JD
• Jennifer Pauline Blythe, O.TR/L
• Annette Boatswain, PA-C
• Donna M. Bodnar, MD

• Acute Care Nurse Practitioner in Napa, CA
• Providers in Napa, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.