COOPER WALLACE BLOYD MD
NPI 1427634963
Pediatrics in San Rafael, CA

Q: What is Cooper Bloyd's NPI number?

The NPI number for Cooper Bloyd is 1427634963. It was assigned to this individual provider in the NPPES registry on March 23, 2021.

Q: What is Cooper Bloyd's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Cooper Bloyd was last updated on August 26, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 23, 2021PECOS Enrolled

1650 LOS GAMOS DR, SAN RAFAEL, CA 94903(415) 444-4460 Get Directions Write a Review

NPPES record last updated: August 26, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 17, 2022, Mar 23, 2021 (2 updates tracked since 2021).

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About Cooper Wallace Bloyd Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COOPER WALLACE BLOYD MD (NPI 1427634963) is an individual pediatrics provider in San Rafael, California, licensed in California (A183168) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1427634963

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameCOOPER WALLACE BLOYDCredential: MD

Location Address1650 LOS GAMOS DRSan Rafael, CA 94903-1850

Mailing Address708 Butternut DrSan Rafael, CA 94903-3124 · (415) 637-9508

Phone(415) 444-4460

Sole ProprietorNo

Enumeration DateMarch 23, 2021

Last NPPES UpdateAugust 26, 20242 updates tracked since enumeration

NPPES CertifiedAugust 26, 2024

✔ NPI 1427634963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in CA · A183168

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1650 LOS GAMOS DR, San Rafael, CA 94903

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cooper Wallace Bloyd Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94903 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.67 typical visit price

range $69.07 – $202.63

Typical copayment $26.16 (range $17.26 – $50.65)

Most-billed visit code 99203

Established Patient

$119.61 typical visit price

range $23.44 – $166.64

Typical copayment $29.90 (range $5.86 – $41.66)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.