Individual provider Active NPI

Linda Marlane Bloom, MD

  • Pediatrics Physician
  • West Reading, PA
National Provider Identifier
1861655995
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD446715 Issued in PA
Practice address
420 S 5TH Ave
West Reading, PA 19611-2143
Phone
(484) 628-2501
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD446715 PA Primary

Addresses

Primary practice location

420 S 5TH Ave
West Reading, PA 19611-2143

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-0799

Other practice location 1

6th Ave and Spruce Street
West Reading, PA 19611-1428
Phone (610) 988-4831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20121115000054 PA Practitioner - HospitalistPractitioner - Pediatric Medicine 2567637846 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
261451NYMDLicensed Practical Nurse
MD446715PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group CurrentSince Sep 29, 2012 Accepting new patients
Tower Health Medical Group CurrentSince Sep 29, 2012 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Reading Hospital Pediatrics Past Accepting new patients

Locations

6 Spruce St
West Reading, PA 19611
Phone (484) 628-8269

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1861655995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-0799",
            "fax_number": "484-334-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S 5TH AVE",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196112143",
            "telephone_number": "484-628-2501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6th Ave and Spruce Street",
            "address_purpose": "LOCATION",
            "city": "West Reading",
            "state": "PA",
            "postal_code": "196111428",
            "country_code": "US",
            "telephone_number": "610-988-4831",
            "fax_number": "610-288-4311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "LINDA",
        "middle_name": "MARLANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD446715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Reading, PA

Sources for this page

Verify at the official NPI Registry.