Ilyse Bloom, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1739 Issued in CO

Practice address

3100 Arapahoe Ave Ste 101
Boulder, CO 80303-1050

Phone

(130) 393-1849

NPI assigned

May 18, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Nova Southeastern College of Osteo Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Ilyse Bloom, LLC

  • Marriage & Family Therapist
  • Boulder, CO
  • NPI 1053107359
  Medicare reassignment NPD Authorized official
• Steinberg Optometry, P.C.

  • Optometrist
  • Boulder, CO
  • NPI 1114175684
  NPD

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1821662396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 ARAPAHOE AVE STE 101",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031050",
            "telephone_number": "130-393-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 ARAPAHOE AVE STE 101",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031050",
            "telephone_number": "130-393-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "ILYSE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "1739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Block, MA, LMFT
• Carrie Bloethner
• Marsden Scott Blois IV, MD
• Jill Blomer, MEDICAL RECEPTIONIST
• Matthew H Blomquist, M.D.
• Blooming Acupuncture
• Bloomspace PLLC
• Blue Hills Counseling LLC
• Blue Sage Transitions Therapy, PLLC
• Blue Sky Foot & Ankle

• Marriage & Family Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Marriage & Family Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.