Larry Jay Bloom, PHD is a medicare enrolled "Psychologist - Health Service" provider in Ft Collins, Colorado. His current practice location is
Of Psychology Colorado State University, Ft Collins, Colorado. You can reach out to his office (for appointments etc.) via phone at
(970) 491-5214.
Larry Jay Bloom is licensed to practice in Colorado (license number 500) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1407878051.
Healthcare Provider's Profile
Full Name | Larry Jay Bloom |
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Gender | Male |
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Speciality | Psychologist - Health Service |
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Location | Of Psychology Colorado State University, Ft Collins, Colorado |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1407878051
- Provider Enumeration Date: 07/24/2006
- Last Update Date: 07/28/2010
Medicare PECOS Information:
- PECOS PAC ID: 4688866791
- Enrollment ID: I20191119000519
Medical Identifiers
Medical identifiers for Larry Jay Bloom such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407878051 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TH0100X | Psychologist - Health Service | 500 (Colorado) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larry Jay Bloom is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Larry Jay Bloom, PHD 1000 Southpark Drive, Littleton, CO 80120-5654 Ph: (303) 715-2264 | Larry Jay Bloom, PHD Of Psychology Colorado State University, Ft Collins, CO 80523-0001 Ph: (970) 491-5214 |
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