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NICK THOMAS VANDER BLOOMEN PMHNP
NPI 1578146296
Nurse Practitioner - Psychiatric/Mental Health in Oshkosh, WI

Active since April 30, 2021PECOS Enrolled
1505 NORTH DR, OSHKOSH, WI 54901(920) 426-4310 Get Directions Write a Review

NPPES record last updated: April 30, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nick Thomas Vander Bloomen Pmhnp NPPES

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

NICK THOMAS VANDER BLOOMEN PMHNP (NPI 1578146296) is an individual psychiatric/mental health provider in Oshkosh, Wisconsin, licensed in Wisconsin (10856) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and is a graduate of University Of Wisconsin School Of Medicine (2011).

NPPES Registry Identity

NPI1578146296
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameNICK THOMAS VANDER BLOOMENCredential: PMHNP
Location Address1505 NORTH DROshkosh, WI 54901
Mailing Address13936 Rosecrans RdMaribel, WI 54227-9717 · (920) 866-8346
Phone(920) 426-4310
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2011
Enumeration DateApril 30, 2021
NPPES CertifiedApril 5, 2021
✔ NPI 1578146296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in WI · 10856
1505 NORTH DR, Oshkosh, WI 54901
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners, Network Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nick Thomas Vander Bloomen Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9739658618
PECOS Enrollment IDI20260520002277
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.

Medicare Billing Reassignment

Medicare enrollment records show Nick Vander Bloomen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bay Psychiatry Of Wisconsin LLC
88 mi
Psychiatric/Mental Health
7353 HORSESHOE BAY RD
Egg Harbor, WI 54209
  • Reassigned Medicare billing, Wisconsin enrollment
  • 6 clinicians in this Medicare group
NPI 1376438135 (920) 238-8155

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54901 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

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 Nick Vander Bloomen's NPI number?

The NPI number for Nick Vander Bloomen is 1578146296. It was assigned to this individual provider in the NPPES registry on April 30, 2021.

Where is Nick Vander Bloomen located?

Nick Vander Bloomen practices at 1505 North Dr, Oshkosh, WI 54901. The listed phone number is (920) 426-4310.

What is Nick Vander Bloomen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Nick Vander Bloomen enrolled in Medicare?

Yes. Nick Vander Bloomen is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nick Vander Bloomen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nick Vander Bloomen reassigns Medicare benefits to Bay Psychiatry Of Wisconsin LLC (Egg Harbor, WI). The 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 Nick Vander Bloomen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nick Vander Bloomen accept?

Health plans from Anthem Blue Cross and Blue Shield, HealthPartners, Network Health and UnitedHealthcare list Nick Vander Bloomen 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 Nick Vander Bloomen was last updated on April 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.