Individual provider Active NPI

Stephen C Bloom, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Ypsilanti, MI
National Provider Identifier
1912940412
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5101011059 Issued in MI
Practice address
5333 McAuley Drive
Suite 2009
Ypsilanti, MI 48197-1014
Phone
(734) 712-0050
Fax
(734) 712-0055
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5101011059 MI Primary

Addresses

Primary practice location

5333 McAuley Drive
Suite 2009
Ypsilanti, MI 48197-1014

Mailing address

5333 McAuley Drive
Suite 2009
Ypsilanti, MI 48197-1014
Phone (734) 712-0050

Other identifiers 2

IdentifierTypeStateIssuer
3086170MedicaidMI
SB011059OtherMISTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephen.bloom@stjoeshealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20091015000300 MI Practitioner - Physical Medicine and Rehabilitation 7416004833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Michigan State University College of Osteopathic Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associates in Physical Medicine and Rehabilitation PCGroup PAC ID 2163481854, 15 clinicians

Practice addresses (Care Compare)

5333 McAuley Dr
RM 2009
Ypsilanti, MI 48197-1095
Phone (734) 712-0077

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
  • Chelsea Hospital Hospital, Chelsea, MI, CCN 230259
  • Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069
  • St. Joseph Mercy Hospital-Ann Arbor Inpatient rehabilitation facility, Ann Arbor, MI, CCN 23T156

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Physical Medicine & Rehabilitation, P.C. Current Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients
Rehabilitation & Physical Medicine Specialists, P.C. Physical Medicine & Rehabilitation PastSince Oct 1, 2002 Accepting new patients

Locations

5333 McAuley Dr
Rm 2009
Ypsilanti, MI 48197
Phone (313) 434-6660

Interoperability endpoints

  • Direct secure messaging: sbloom40736@direct.trinity-health.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1912940412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DRIVE",
            "address_2": "SUITE 2009",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971014",
            "telephone_number": "734-712-0050",
            "fax_number": "734-712-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DRIVE",
            "address_2": "SUITE 2009",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971014",
            "telephone_number": "734-712-0050",
            "fax_number": "734-712-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "STEPHEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101011059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086170",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SB011059",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephen.bloom@stjoeshealth.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "5333 McAuley Drive",
            "address_2": "Suite 2009",
            "city": "Ypsilanti",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481971014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.