Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Scott Phillip Bloom

Individual provider Family Medicine Physician · NPI 1457432171

Scott Phillip Bloom is a Family Practice in Jericho, New York. Qualified in 1983, 43 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
43
Licensed in
NY
In the registry since
2006

Practice location Address checks out

380 N Broadway Ste 307
Jericho, NY 11753-2109
Phone: (516) 835-4092
Fax: (516) 338-2901
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 162996 (NY)

Record details

NPI number1457432171
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 18, 2006
Last updated in NPPESMay 29, 2023
Certification dateMay 29, 2023
Mailing address380 N Broadway Ste 307, Jericho, NY 11753-2109

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1983 (43 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Jericho