DR. JACOB CAMERON BLOOM (NPI# 1760942494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760942494 |
| Entity Type | Individual |
| Full Name | DR. JACOB CAMERON BLOOM |
| Credential | MD |
| Practice Address |
830 Harrison Ave Fl 1 Boston MA 02118-2905 |
| Practice Telephone | 6176388124 |
| Mailing Telephone | 6176388124 |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-07-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770757130 | Jacob Maxwell-phillip Bloom | Plastic Surgery | 1 E Delaware Pl Ste 501, Chicago, IL 60611 | 2008-04-16 |
| 1730712308 | Jacob Bloom | Counselor | 4076 Kothlow Ave, Menomonie, WI 54751-3090 | 2020-02-21 |
| Street Address |
830 HARRISON AVE FL 1 |
| City | BOSTON |
| State | MA |
| Zip Code | 02118-2905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497259212 | Michal Plocienniczak | Otolaryngology | 830 Harrison Ave Fl 1, Boston, MA 02118-2905 | 2018-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
| Find all providers in zip 02118 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447636 | Sarah Wieman | Student in an Organized Health Care Education/Training Program | 16 Blossom St Fl 1, Boston, MA 02114-3104 | 2020-11-03 |
| 1932709938 | Brianna Mae Duval | Student in an Organized Health Care Education/Training Program | 58 Colborne Rd, Boston, MA 02135-4103 | 2020-10-28 |
| 1780281279 | Sarah Hamad Alsaggabi | Student in an Organized Health Care Education/Training Program | 55 Traveler St Apt 1310, Boston, MA 02118-2973 | 2020-10-07 |
| 1821695933 | Matthew John Needham | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 | 2020-10-02 |
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1558978957 | Tien-hsin Chang | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street (tufts University School of Dental Me, Boston, MA 02111 | 2020-09-29 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1962018069 | Cara Connors | Student in an Organized Health Care Education/Training Program | 18 Wiget St Apt 1, Boston, MA 02113-2363 | 2020-09-23 |
| 1023624608 | Bernadette Avila | Student in an Organized Health Care Education/Training Program | 19 Peterborough St Apt 5, Boston, MA 02215-4409 | 2020-09-19 |
| 1588276281 | Guoliang Qiao | Student in an Organized Health Care Education/Training Program | Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 | 2020-08-24 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.