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BRIANNA ELAINA BLOOM
NPI 1619647427
Counselor - Mental Health in Vinita, OK

Active since September 14, 2021PECOS EnrolledAccepts Medicare Assignment
405 E EXCELSIOR AVE, VINITA, OK 74301(918) 256-6476(918) 256-3628 Get Directions Write a Review

NPPES record last updated: September 14, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Brianna Elaina Bloom NPPES

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

BRIANNA ELAINA BLOOM (NPI 1619647427) is an individual mental health provider in Vinita, Oklahoma and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS and is a graduate of Other.

NPPES Registry Identity

NPI1619647427
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameBRIANNA ELAINA BLOOM
Location Address405 E EXCELSIOR AVEVinita, OK 74301-4226
Mailing Address405 E Excelsior AveVinita, OK 74301-4226
Phone(918) 256-6476
Fax(918) 256-3628
Sole ProprietorNo
Medical School CMSOther
Enumeration DateSeptember 14, 2021
NPPES CertifiedSeptember 14, 2021
✔ NPI 1619647427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
405 E EXCELSIOR AVE, Vinita, OK 74301
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brianna Elaina Bloom 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 ID5799216982
PECOS Enrollment IDI20240927003190
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 Brianna Bloom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grand Lake Mental Health Center Inc.
Same address
Mental Health (Including Community Mental Health Center)
405 E EXCELSIOR AVE
Vinita, OK 74301
  • Reassigned Medicare billing, Oklahoma enrollment
  • 333 clinicians in this Medicare group
NPI 1679983696 (918) 256-6476

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

Other Providers at the Same Location NPPES 20

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

ANISSA MARIE MAYHEW
Case Manager/Care Coordinator
405 E EXCELSIOR AVE
VINITA, OK 74301
Craig County (918) 245-6476
KARLEE GIBSON
Peer Specialist
405 E EXCELSIOR AVE
VINITA, OK 74301
Craig County (918) 256-6476
CHRSITINA HART
Peer Specialist
405 E EXCELSIOR AVE
VINITA, OK 74301
Craig County (918) 256-6476
JUSTIN LYNN CICOTTE
Peer Specialist
405 E EXCELSIOR AVE
VINITA, OK 74301
Craig County (918) 256-6476
STEVEN RAY COATNEY
Peer Specialist
405 E EXCELSIOR AVE
VINITA, OK 74301
Craig County (918) 256-6476
ELISABETH TENNEH BIMBA
Registered Nurse
405 E EXCELSIOR AVE
VINITA, OK 74301
Craig County (918) 256-6476
KIMBERLY ANN CASHION
Peer Specialist
405 E EXCELSIOR AVE
VINITA, OK 74301
Craig County (918) 344-1577
CHRYSTAL BRASSFIELD MS
Counselor (Mental Health)
405 E EXCELSIOR AVE
VINITA, OK 74301
Craig County (918) 256-6476

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 Brianna Bloom's NPI number?

The NPI number for Brianna Bloom is 1619647427. It was assigned to this individual provider in the NPPES registry on September 14, 2021.

Where is Brianna Bloom located?

Brianna Bloom practices at 405 E Excelsior Ave, Vinita, OK 74301. The listed phone number is (918) 256-6476.

What is Brianna Bloom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Brianna Bloom enrolled in Medicare?

Yes. Brianna 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.

Which organization bills Medicare for Brianna Bloom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brianna Bloom reassigns Medicare benefits to Grand Lake Mental Health Center Inc. (Vinita, OK). 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 Brianna Bloom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Brianna Bloom accept?

Health plans from Blue Cross and Blue Shield of Oklahoma and Oscar Insurance Company list Brianna Bloom 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 Brianna Bloom was last updated on September 14, 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.