Jacob Maxwell-Phillip Bloom, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

036134552 Issued in IL

Practice address

1 E Delaware PL Ste 501
Chicago, IL 60611-1666

Phone

(312) 549-8691

Fax

(312) 549-8692

NPI assigned

Apr 16, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Plastic and Reconstructive SurgeryAlso: Hand Surgery

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bloom Plastic Surgery SCGroup PAC ID 3870836208, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbloom@directaddress.net

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.

• Bloom Plastic Surgery SC

  • Specialist
  • Chicago, IL
  • NPI 1457805244
  Medicare reassignment Care Compare group NPD Authorized official
• Physicians Dermpath Laboratory

  • Dermatopathology Physician
  • Park Ridge, IL
  • NPI 1376866897
  NPD (past)

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

• Delnor Community Hospital

  dba Northwestern Medicine Delnor Community Hospital

  • General Acute Care Hospital
  • Geneva, IL
  • NPI 1407859655
  Care Compare affiliation

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1770757130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E DELAWARE PL STE 501",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606111666",
            "telephone_number": "312-535-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E DELAWARE PL STE 501",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606111666",
            "telephone_number": "312-549-8691",
            "fax_number": "312-549-8692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Salt Creek Ln Ste 125",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605218646",
            "country_code": "US",
            "telephone_number": "312-549-8691",
            "fax_number": "312-549-8692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "JACOB",
        "middle_name": "MAXWELL-PHILLIP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "IL",
            "license": "036134552",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": "036134552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbloom@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF",
            "address_1": "1 E Delaware Pl Ste 501",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606111666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bloom Therapy LLC
• Bloom Wellness LLC (Mind Body Family)
• Bari Bloom
• Carolyn Bloom
• Corinne Bloom
• Jamie Lawrence Bloom, MD
• Karin Beth Bloom, MSW,LCSW
• Leah Bloom
• Lisa Robyn Bloom
• Spencer Robert Bloom, DDS

• Plastic and Reconstructive Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Plastic and Reconstructive Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.