Active NPI
Nicole Anne Bloor, MD
- Adolescent Medicine (Internal Medicine) Physician
- Wakefield, MA
National Provider Identifier
1861468233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent Medicine (Internal Medicine) Physician
- License
- 80960
- Practice address
- 888 Main St Ste 101
Wakefield, MA 01880-4080 - Phone
- (781) 620-4888
- Fax
- (781) 245-2602
- NPI assigned
- Feb 27, 2006
- Last updated
- Mar 2, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 80960 | MA | |
| Adolescent Medicine (Internal Medicine) Physician | 207RA0000X | 80960 | MA | Primary |
Addresses
Primary practice location
888 Main St Ste 101
Wakefield, MA 01880-4080
Mailing address
PO Box 3237
Woburn, MA 01888-3237
Phone (781) 338-7170
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B10318801 | Other | MA | CIGNA |
| 66934 | Other | MA | HP |
| 9700480 | Medicaid | MA | |
| 3140016 | Medicaid | MA | |
| 989581 | Other | MA | NETWORK HEALTH |
| 080960 | Other | MA | TUFTS |
| M17510 | Other | MA | BC - GROUP # |
| J31895 | Other | MA | BC |
| 0401949 | Other | MA | UH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80960 | MA | MD | Internal Medicine Physician |
Interoperability endpoints
- nbloor28528@tuftsmedicine.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583107200000",
"number": "1861468233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3237",
"city": "WOBURN",
"state": "MA",
"postal_code": "018883237",
"telephone_number": "781-338-7170",
"fax_number": "781-338-7173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "888 MAIN ST STE 101",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018804080",
"telephone_number": "781-620-4888",
"fax_number": "781-245-2602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOR",
"first_name": "NICOLE",
"middle_name": "ANNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-27",
"last_updated": "2020-03-02",
"certification_date": "2020-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "80960",
"primary": false
},
{
"code": "207RA0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Adolescent Medicine",
"state": "MA",
"license": "80960",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "B10318801",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HP",
"identifier": "66934",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9700480",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3140016",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "989581",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "080960",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC - GROUP #",
"identifier": "M17510",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC",
"identifier": "J31895",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UH",
"identifier": "0401949",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wakefield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.