BLOOM PRIMARY TX, PLLC
NPI 1275901340
Family Medicine in Southlake, TX
About Bloom Primary Tx, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLOOM PRIMARY TX, PLLC (NPI 1275901340) is a healthcare organization registered as a family medicine in Southlake, Texas and active in the NPI registry since September 2015. The organization lists Debra Kay Moon Wadelton, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bloom Primary Tx, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Bloom Primary Tx, PLLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Bloom Primary Tx, PLLC's NPI number?
The NPI number for Bloom Primary Tx, PLLC is 1275901340. It was assigned to this organization in the NPPES registry on September 8, 2015.
Where is Bloom Primary Tx, PLLC located?
Bloom Primary Tx, PLLC is located at 545 S Nolen Dr, Southlake, TX 76092. The listed phone number is (303) 993-1330.
What is Bloom Primary Tx, PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Bloom Primary Tx, PLLC enrolled in Medicare?
Yes. Bloom Primary Tx, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bloom Primary Tx, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Bloom Primary Tx, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4) and Internal Medicine (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Bloom Primary Tx, PLLC accept?
Health plans from Blue Cross and Blue Shield of Texas list Bloom Primary Tx, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Bloom Primary Tx, PLLC was last updated on September 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Bloom Primary Tx, Pllc · NPI 1275901340
Family Medicine organization in Southlake, Texas. Organization record, active in the CMS NPPES registry since September 8, 2015.
## Identity
- **NPI:** 1275901340 (Entity type: Organization)
- **Enumerated:** September 8, 2015
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Debra Moon Wadelton, AUTHORIZED OFFICIAL
## Practice location
- **Address:** 545 S NOLEN DR, Southlake, TX 76092-9176
- **Phone:** (303) 993-1330
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (4), Internal Medicine (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1275901340) · Data from the CMS NPPES public registry.