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KATHLEEN BLOOM
NPI 1952794950
Counselor - Professional in Grand Rapids, MI

Active since March 15, 2015PECOS EnrolledAccepts Medicare Assignment
1558 PINE AVE NW, GRAND RAPIDS, MI 49504(616) 901-2777(616) 336-4333 Get Directions Write a Review

NPPES record last updated: March 15, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kathleen Bloom NPPES

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

KATHLEEN BLOOM (NPI 1952794950) is an individual professional provider in Grand Rapids, Michigan, licensed in Michigan (6401001493) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS and is a graduate of Other (1987).

NPPES Registry Identity

NPI1952794950
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKATHLEEN BLOOM
Location Address1558 PINE AVE NWGrand Rapids, MI 49504-3029
Mailing Address1558 Pine Ave NwGrand Rapids, MI 49504-3029 · (616) 901-2777 · Fax (616) 336-4333
Phone(616) 901-2777
Fax(616) 336-4333
Sole ProprietorYes
Medical School CMSOtherGraduated 1987
Enumeration DateMarch 15, 2015
✔ NPI 1952794950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MI · 6401001493
1558 PINE AVE NW, Grand Rapids, MI 49504
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Other Identifiers 1

Medicaid101YO2500XMI

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

Kathleen 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 ID8325516834
PECOS Enrollment IDI20260504005579
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.

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 Kathleen Bloom's NPI number?

The NPI number for Kathleen Bloom is 1952794950. It was assigned to this individual provider in the NPPES registry on March 15, 2015.

Where is Kathleen Bloom located?

Kathleen Bloom practices at 1558 Pine Ave NW, Grand Rapids, MI 49504. The listed phone number is (616) 901-2777.

What is Kathleen Bloom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kathleen Bloom enrolled in Medicare?

Yes. Kathleen 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 Kathleen Bloom was last updated on March 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.