Individual provider Active NPI

Andrew James Bloom

  • Primary Podiatric Medicine Podiatrist
  • Englewood, NJ
National Provider Identifier
1750919957
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
25MD00373000 Issued in NJ
Practice address
142 Engle St
Englewood, NJ 07631-2547
Phone
(201) 568-0033
NPI assigned
Apr 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 25MD00373000 NJ Primary

Addresses

Primary practice location

142 Engle St
Englewood, NJ 07631-2547

Mailing address

142 Engle St
Englewood, NJ 07631-2547

Other identifiers 1

IdentifierTypeStateIssuer
0908096MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230616000220 NJ Practitioner - Podiatry 6507224995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

142 Engle St
Englewood, NJ 07631-2507
Phone (201) 568-0033

Hospital & facility affiliations

  • Visiting Nurse Association of Englewood, Inc Home health agency, Englewood, NJ, CCN 317022
  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045
  • Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue97
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00373000NJMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC CurrentSince Jul 17, 2023 Accepting new patients
University Physician Associates of New Jersey Inc PastSince Apr 1, 2020 Accepting new patients

Locations

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

50 Polifly Rd
Hackensack, NJ 07601
Phone (201) 646-1166

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

2 Journal Square Plz
Ste 2
Jersey City, NJ 07306
Phone (201) 963-7000

150 Bergen St
#G142
Newark, NJ 07103
Phone (201) 638-4061

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1750919957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312547",
            "telephone_number": "201-568-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NJ",
            "license": "25MD00373000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0908096",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.