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BLOOMING MEDICAL GROUP, PLLC
NPI 1750041497
Physician Assistant in Cary, NC

Active since December 21, 2021
964 HIGH HOUSE RD UNIT 4037, CARY, NC 27513(910) 644-0887 Get Directions Write a Review

NPPES record last updated: January 31, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 31, 2023, Dec 22, 2021 (2 updates tracked since 2021).

About Blooming Medical Group, Pllc NPPES

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

BLOOMING MEDICAL GROUP, PLLC (NPI 1750041497) is a healthcare organization registered as a physician assistant in Cary, North Carolina and active in the NPI registry since December 2021. The organization lists Emily Becker Pevtsov, Owner, as its authorized official.

NPPES Registry Identity

NPI1750041497
Entity TypeOrganization
Primary Taxonomy363A00000X
Legal Business NameBLOOMING MEDICAL GROUP, PLLC
Location Address964 HIGH HOUSE RD UNIT 4037Cary, NC 27513-3574
Mailing Address964 High House Rd Unit 4037Cary, NC 27513-3574
Phone(910) 644-0887
Organization SubpartNo
Authorized OfficialEmily Becker PevtsovOwner · (910) 644-0887
Enumeration DateDecember 21, 2021
Last NPPES UpdateJanuary 31, 20232 updates tracked since enumeration
NPPES CertifiedDecember 22, 2021
✔ NPI 1750041497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
964 HIGH HOUSE RD UNIT 4037, Cary, NC 27513
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Other Identifiers 1

Medicaid00414600NC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of NC, Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blooming Medical Group, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNorth CarolinaEnrollment IDO20220324002254Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

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 Blooming Medical Group, PLLC's NPI number?

The NPI number for Blooming Medical Group, PLLC is 1750041497. It was assigned to this organization in the NPPES registry on December 21, 2021.

Where is Blooming Medical Group, PLLC located?

Blooming Medical Group, PLLC is located at 964 High House Rd Unit 4037, Cary, NC 27513. The listed phone number is (910) 644-0887.

What is Blooming Medical Group, PLLC's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Blooming Medical Group, PLLC enrolled in Medicare?

Yes. Blooming Medical Group, PLLC is registered in the Medicare PECOS enrollment system.

When is Blooming Medical Group, PLLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (North Carolina, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

What insurance does Blooming Medical Group, PLLC accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of NC and Cigna Healthcare list Blooming Medical Group, PLLC 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 Blooming Medical Group, PLLC was last updated on January 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.