Ilene S Bloom, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C01316 Issued in MD

Practice address

116 Defense Hwy
Suite 400
Annapolis, MD 21401-7027

Phone

(410) 897-9841

Fax

(410) 897-9852

NPI assigned

Nov 28, 2006

Last updated

Aug 13, 2014By 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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Titus C. Abraham, MD, LLC

  • Internal Medicine Physician
  • Annapolis, MD
  • NPI 1407295967
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1790851996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 DEFENSE HWY",
            "address_2": "SUITE 400",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017027",
            "telephone_number": "410-897-9841",
            "fax_number": "410-897-9852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 DEFENSE HWY",
            "address_2": "SUITE 400",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017027",
            "telephone_number": "410-897-9841",
            "fax_number": "410-897-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "ILENE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C01316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "C001316",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad Richard Blaszczyk, PHARMD
• Parker Bledsoe, DPT
• Mary Ann Bleeke, LCSW-C, CEAP
• Kaylenna Blessing, PTA
• Noel Christine Blizzard
• Stella Lii Blosser, MD, MPH
• Blue Heron Psychology, LLC
• Mollie Blum
• Bluzone
• Cary Bly, DDS

• Medical Physician Assistant in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.