Ellis Bloom, DO
NPI 1124875059 · Student in an Organized Health Care Education/Training Program · Providence, RI
Enrolled with Medicare as Order and Referring Only - Emergency Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ellis Bloom, DO is a Student in an Organized Health Care Education/Training Program provider in Providence, RI (NPI 1124875059).
Provider details
- NPI number
- 1124875059
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- LP06198 (RI)
Specialties & taxonomies
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-04-30
- Last updated
- 2024-04-30
- Certified
- 2024-04-30
Frequently asked questions
- What is Ellis Bloom's NPI number?
- Ellis Bloom's National Provider Identifier (NPI) is 1124875059, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ellis Bloom's specialty?
- Ellis Bloom is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).
- Where is Ellis Bloom located?
- Ellis Bloom's practice location on file with NPPES is 593 Eddy St, Providence, RI 02903-4923.
- What is Ellis Bloom's phone number?
- The practice phone number listed in the NPPES registry for Ellis Bloom is (401) 793-2695.
- Does Ellis Bloom accept Medicare?
- Ellis Bloom is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Ellis Bloom's NPI active?
- Yes — Ellis Bloom's NPI (1124875059) is active in the NPPES registry as of the last update on 2024-04-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.