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KENNETH EDWARD BLOOM M.D.
NPI 1477536068
Dermatology in Bronx, NY

Active since November 28, 2005PECOS EnrolledAccepts Medicare Assignment
1455 WEST AVE, BRONX, NY 10462(718) 239-1500(212) 765-3210 Get Directions Write a Review

NPPES record last updated: August 22, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kenneth Edward Bloom M.d. NPPES

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

KENNETH EDWARD BLOOM M.D. (NPI 1477536068) is an individual dermatology provider in Bronx, New York, licensed in New York (169466) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Rush Medical College Of Rush University (1984).

NPPES Registry Identity

NPI1477536068
Entity TypeIndividualMale
Primary Taxonomy207N00000X
Provider Legal NameKENNETH EDWARD BLOOMCredential: M.D.
Location Address1455 WEST AVEBronx, NY 10462-7304
Mailing Address200 Central Park S Apt 107New York, NY 10019-1449 · (212) 262-2500 · Fax (212) 765-3210
Phone(718) 239-1500
Fax(212) 765-3210
Sole ProprietorNo
Medical School CMSRush Medical College Of Rush UniversityGraduated 1984
Enumeration DateNovember 28, 2005
Last NPPES UpdateAugust 22, 2019
✔ NPI 1477536068 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in NY · 169466
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
1455 WEST AVE, Bronx, NY 10462
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Secondary Practice Locations 3

Location 12100 Bartow Ave Ste 211Bronx, NY 10475-4614 · Phone (718) 671-1000 · Fax (212) 765-3210
Location 2291 E 149th StBronx, NY 10451-5601 · Phone (718) 671-1000 · Fax (212) 765-3210
Location 32432 Grand Concourse Rm 501Bronx, NY 10458-5204 · Phone (718) 537-5000 · Fax (212) 765-3210

Other Identifiers 1

Medicaid04134401NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kenneth Edward Bloom M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163429457
PECOS Enrollment IDI20150609001213
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
29 services16 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
17 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10462 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MIKE DAVID
Physician Assistant
1455 WEST AVE
BRONX, NY 10462
Bronx County (718) 239-1500
ADVANCED DERMATOLOGY OF NEW YORK, P.C.
Specialist
1455 WEST AVE
BRONX, NY 10462
Bronx County (212) 262-2500
ANGELA AMERICA LIBRANTI PA
Physician Assistant
1455 WEST AVE
BRONX, NY 10462
Bronx County (718) 239-1500

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 Kenneth Bloom's NPI number?

The NPI number for Kenneth Bloom is 1477536068. It was assigned to this individual provider in the NPPES registry on November 28, 2005.

Where is Kenneth Bloom located?

Kenneth Bloom practices at 1455 West Ave, Bronx, NY 10462. The listed phone number is (718) 239-1500.

What is Kenneth Bloom's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Kenneth Bloom enrolled in Medicare?

Yes. Kenneth Bloom is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kenneth Bloom was last updated on August 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.