Shane Taylor Bloom, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2570 Issued in NE

Practice address

1500 S 48TH St Ste 800
Lincoln, NE 68506-1200

Phone

(402) 483-8600

Fax

(402) 483-8689

NPI assigned

Feb 4, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NE

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

Physician Assistant

Education

University of Nebraska College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nebraska Orthopaedic Center PC 65 clinicians

Neurological and Spinal Surgery LLC 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bryan Medical Center Hospital, Lincoln, NE, CCN 280003
• Fillmore County Hospital Hospital, Geneva, NE, CCN 281301
• Thayer County Health Services Hospital, Hebron, NE, CCN 281304
• CHI Health St. Elizabeth Hospital, Lincoln, NE, CCN 280020
• Lincoln Surgical Hospital Hospital, Lincoln, NE, CCN 280127
• Madonna Rehabilitation Hospital Lincoln Inpatient rehabilitation facility, Lincoln, NE, CCN 283025

Merit-based Incentive Payment System (MIPS)

Final score

87.8 of 100Reported as group

Quality

89.76

Promoting interoperability

99

Improvement activities

40

Cost

70.41

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: shane.bloompac.p1@direct.neuroandspinalsurg.nextgenshare.com
• Direct secure messaging: shane.bloom.1@32860.direct.athenahealth.com

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.

• Nebraska Orthopaedic Center PC

  • Orthopaedic Surgery Physician
  • Lincoln, NE
  • NPI 1659349330

  NE

  Medicare reassignment Care Compare group NPD
• Neurological and Spinal Surgery LLC

  • Neurological Surgery Physician
  • Lincoln, NE
  • NPI 1346206117

  NE

  Medicare reassignment Care Compare group NPD
• Nebraska Orthopaedic Center PC

  • Durable Medical Equipment & Medical Supplies
  • Lincoln, NE
  • NPI 1184379836
  Care Compare group

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

• Bryan Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1528006103

  Hospital

  Care Compare affiliation
• Bryan Medical Center

  • Clinical Medical Laboratory
  • Lincoln, NE
  • NPI 1689203077

  Hospital

  Care Compare affiliation
• Bryan Medical Center

  • Diagnostic Radiology Physician
  • Lincoln, NE
  • NPI 1699384370

  Hospital

  Care Compare affiliation
• Fillmore County Hospital

  • Critical Access Hospital
  • Geneva, NE
  • NPI 1689769382

  Hospital

  Care Compare affiliation
• Lincoln Surgery Center LLC

  • Special Hospital
  • Lincoln, NE
  • NPI 1306849005

  Hospital

  Care Compare affiliation
• Madonna Rehabilitation Hospital

  • Rehabilitation Hospital
  • Lincoln, NE
  • NPI 1558458091

  Inpatient rehabilitation facility

  Care Compare affiliation
• Saint Elizabeth Regional Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1336155738

  Hospital

  Care Compare affiliation
• Thayer County Memorial Hospital

  • Critical Access Hospital
  • Hebron, NE
  • NPI 1326029984

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1720670482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S 48TH ST STE 800",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061200",
            "telephone_number": "402-483-8600",
            "fax_number": "402-483-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S 48TH ST STE 800",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061200",
            "telephone_number": "402-483-8600",
            "fax_number": "402-483-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "SHANE",
        "middle_name": "TAYLOR",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbloom@nps.ssdirect.aprima.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Message STB",
            "affiliationName": "Nebraska Pulmonary Specialties LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1500 S 48th St",
            "address_2": "Suite 800",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685061200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsay Blomker
• Ellie Blomstedt
• Justin Blomstedt
• Michelle Grace Blomstedt
• Bloom Counseling
• Amy A Bloomquist, DPT
• Tessa Marie Blough
• Norah Gwendolyn Blow
• Logan Arnold Blowers
• Blue River Counseling

• All providers in Lincoln, NE
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.