Mona B Bloom, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

H9825 Issued in TX

Practice address

12951 South Fwy
Houston, TX 77047-1923

Phone

(713) 526-5771

Fax

(713) 526-2036

NPI assigned

Nov 3, 2005

Last updated

Dec 4, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mona Susan Bauchsbaum Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

Baylor College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovative Radiology PAGroup PAC ID 2668432782, 39 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as group

Quality

0

Improvement activities

0

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as group

Quality

0

Improvement activities

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

• Innovative Radiology PA

  • Diagnostic Radiology Physician
  • Houston, TX
  • NPI 1568400810
  Medicare reassignment Care Compare group NPD
• Southwest Radiology Assn

  • Diagnostic Radiology Physician
  • Webster, TX
  • NPI 1275521718
  NPD (past)

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1760473193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4346",
            "address_2": "DEPT 401",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104346",
            "telephone_number": "713-331-1850",
            "fax_number": "713-521-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12951 SOUTH FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770471923",
            "telephone_number": "713-526-5771",
            "fax_number": "713-526-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "MONA",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "H9825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONA",
            "last_name": "BAUCHSBAUM",
            "middle_name": "SUSAN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth S Bloom, M.D.
• Judi E Bloom, LPC
• Kerry Mark Bloom, D.D.S.
• Manuel G Bloom Jr., M.D
• Martin L Bloom, M.D.
• Olivia Bloom
• Bloomcare & Co LLC
• David M Bloome, M.D.
• Bloomhaven Wellness Center (Bloomhaven Wellness Retreats)
• Blooming Arc Psychiatric Care PLLC

• Diagnostic Radiology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.