Lee Scott Bloemendal, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

L8284 Issued in TX

Practice address

1325 Pennsylvania Ave
Suite 720
Fort Worth, TX 76104-2144

Phone

(817) 810-9495

Fax

(817) 336-8941

NPI assigned

Jul 13, 2006

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

Other identifiers 2

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

General Surgery

Education

University of Texas Medical Branch at Galveston, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
• Baylor Scott and White Surgical Hospital Fortworth Hospital, Fort Worth, TX, CCN 450880

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbloemendal@direct.uspi.com
• Direct secure messaging: lee.bloemendal.p1@direct.thc.nextgenshare.com
• Direct secure messaging: scott.bloemendal.p1@direct.thc.nextgenshare.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.

• Texas Health Care, P.L.L.C.

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
  • NPI 1477628873
  Medicare reassignment Care Compare group NPD
• Texas Health Care, P.L.L.C.

  • Otolaryngology Physician
  • Fort Worth, TX
  • NPI 1245686617

  Surgery

  NPD
• Texas Health Care, P.L.L.C.

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1821026352

  Surgery

  NPD
• Texas Health Care, P.L.L.C.

  • Surgery Physician
  • Fort Worth, TX
  • NPI 1417014259
  NPD (past)

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

• Fort Worth Surgicare Partners LTD

  • Special Hospital
  • Fort Worth, TX
  • NPI 1568883775
  Care Compare affiliation
• Fort Worth Surgicare Partners, LTD.

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1871599183
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1790700524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8400",
            "fax_number": "817-336-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE",
            "address_2": "SUITE 720",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042144",
            "telephone_number": "817-810-9495",
            "fax_number": "817-336-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOEMENDAL",
        "first_name": "LEE",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "L8284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165908801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00226493",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blocker Preventive Medicine PLLC
• Candice Lorraine Blocker, OTR, CLT
• Mette Jane Adams Blockhan, O.T.
• Duffy Bloemendal, OTR
• Lee Charles Bloemendal, MD
• Bloom Bilingual Speech Therapy
• Bloom Harbor Collective, PLLC
• Amber Dawn Bloom, LPC-S
• Tyler Lee Bloomer, M.D.
• Becky Bloomfield, PT

• Surgery Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.