Susan P Bloom, PT SCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7494

Practice address

15 Oak Street
Suite 1
Needham, MA 02492

Phone

(781) 444-1614

Fax

(781) 444-9260

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kennedy Brothers Physical Therapy IncGroup PAC ID 9537118187, 6 clinicians

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.

• Kennedy Brothers Physical Therapy Inc.

  • Physical Therapist
  • Needham, MA
  • NPI 1982756854
  Medicare reassignment Care Compare group NPD
• Kennedy Brothers Physical Therapy Inc.

  • Physical Therapist
  • Watertown, MA
  • NPI 1811063803
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1861544819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 OAK STREET",
            "address_2": "SUITE 1",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "02492",
            "telephone_number": "781-444-1614",
            "fax_number": "781-444-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OAK STREET",
            "address_2": "SUITE 1",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "02492",
            "telephone_number": "781-444-1614",
            "fax_number": "781-444-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "SUSAN",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "PT SCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "7494",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "7494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y66501",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Joseph Blank, LCSW
• Debra J. Blattman, DMD
• Tess Blaylock, MSW
• Stuart R Bless
• Bloom Mental Health Services PLLC
• Rebekah Bobeldyk, DPT
• Gladys Bockelman
• Lauren Bolton
• Laurel Mary Bonaccorso
• Adam Bonfilio

• Physical Therapist in Needham, MA
• Providers in Needham, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.