Individual provider Active NPI

Michele Marjorie Bloomer, M.D.

  • Ophthalmology Physician
  • Piedmont, CA
National Provider Identifier
1972600666
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A72716 Issued in CA
Practice address
461 Scenic Ave
Piedmont, CA 94611-3420
Phone
(415) 476-3705
Fax
(415) 476-3511
NPI assigned
Sep 17, 2006
Last updated
Jan 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A72716 CA Primary

Addresses

Primary practice location

461 Scenic Ave
Piedmont, CA 94611-3420

Mailing address

University of California San Francisco
10 Koret Way, RM K220, Box 0730
San Francisco, CA 94143-0001
Phone (415) 476-3705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20060413000728 CA Practitioner - Ophthalmology 6305855693 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Quality
86.78
Improvement activities
40
Cost
70.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72716CAMDMarriage & Family Therapist
A72716CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group CurrentSince Aug 22, 2009 Accepting new patients
University of California San Francisco CurrentSince Mar 25, 2008 Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 4, 2009 Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
UCSF Medical Group Business Services Ophthalmology CurrentSince Nov 4, 2009 Accepting new patients
University of California San Francisco CurrentSince Mar 25, 2008 Accepting new patients
Regents of the University of California CurrentSince Feb 25, 2020 Accepting new patients
University of California SFGH Medical Group Ophthalmology CurrentSince Aug 22, 2009 Accepting new patients
University of California San Francisco Current Accepting new patients
Eyecare Associates of San Francisco, a Medical Group, Inc. Ophthalmology Past Accepting new patients
Kevin Tan, MD and Productions, Inc Ophthalmology Past Accepting new patients

Locations

10 Koret Way
Rm K220
San Francisco, CA 94143

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Rm 3A
San Francisco, CA 94110
Phone (415) 206-4632

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

533 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-7192

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1972600666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF CALIFORNIA SAN FRANCISCO",
            "address_2": "10 KORET WAY, RM K220, BOX 0730",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430001",
            "telephone_number": "415-476-3705",
            "fax_number": "415-476-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 SCENIC AVE",
            "city": "PIEDMONT",
            "state": "CA",
            "postal_code": "946113420",
            "telephone_number": "415-476-3705",
            "fax_number": "415-476-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMER",
        "first_name": "MICHELE",
        "middle_name": "MARJORIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A72716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piedmont, CA

Sources for this page

Verify at the official NPI Registry.