DR. EMANUEL M. DICICCO-BLOOM MD
NPI 1578658720
Pediatrics - Neurodevelopmental Disabilities in New Brunswick, NJ

Q: What is Emanuel Dicicco-bloom's NPI number?

The NPI number for Emanuel Dicicco-bloom is 1578658720. It was assigned to this individual provider in the NPPES registry on October 4, 2006.

Q: What is Emanuel Dicicco-bloom's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neurodevelopmental Disabilities, with taxonomy code 2080P0008X.

Active since October 04, 2006PECOS Enrolled

89 FRENCH ST STE 2300, NEW BRUNSWICK, NJ 08901(732) 235-7875(732) 235-6620 Get Directions Write a Review

NPPES record last updated: July 23, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Emanuel M. Dicicco-bloom Md NPPES

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

DR. EMANUEL M. DICICCO-BLOOM MD (NPI 1578658720) is an individual neurodevelopmental disabilities provider in New Brunswick, New Jersey, licensed in New Jersey (25MA05478100) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578658720

Entity TypeIndividualMale

Primary Taxonomy2080P0008X

Provider Legal NameDR. EMANUEL M. DICICCO-BLOOMCredential: MD

Location Address89 FRENCH ST STE 2300New Brunswick, NJ 08901-1935

Mailing Address66 West Gilbert StRed Bank, NJ 07701 · (732) 212-0051 · Fax (732) 212-0713

Phone(732) 235-7875

Fax(732) 235-6620

Sole ProprietorYes

Enumeration DateOctober 4, 2006

Last NPPES UpdateJuly 23, 2021

NPPES CertifiedJuly 23, 2021

✔ NPI 1578658720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neurodevelopmental DisabilitiesAllopathic & Osteopathic Physicians

Taxonomy Code2080P0008X

Licenses✔ Licensed in NJ · 25MA05478100✔ Licensed in NJ · MA54781

Definition

A pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions.

89 FRENCH ST STE 2300, New Brunswick, NJ 08901

Open in Google Maps ↗

Other Identifiers 1

Medicaid0870706NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Emanuel M. Dicicco-bloom 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.

Other Providers at the Same Location NPPES 5

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

KYLIE KATZ MS

Genetic Counselor, MS