DR. JACOB MAXWELL-PHILLIP BLOOM (MD) – Plastic and Reconstructive Surgery Physician, NPI 1770757130
Plastic and Reconstructive Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
172 HAND SURGERY in IL
Provider Addresses for DR. JACOB MAXWELL-PHILLIP BLOOM (MD)
12 Salt Creek Ln Ste 125
Hinsdale, IL 605218646
Phone: (312) 549-8691
Fax: (312) 549-8692
Type: Location
East Delaware Place, Magnificent Mile, Near North Side, Chicago, Cook County, Illinois, 60611, United States
CHICAGO, IL 606111666
Phone: (312) 535-3721
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $607.
Total Amount is formed as General ($607) + Research ($0) + Ownership ($0) = $607.
Last reported payment date: 2024-10-30 • Largest payer in this snapshot: MOTIVA USA, LLC ($328).
Total Amount
$607
General + Research + Ownership
Payments
16
Total payment records
General Amount
$607
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| MOTIVA USA, LLC | $328 |
| Galderma Laboratories, L.P. | $164 |
| ABBVIE INC. | $74 |
| Pacira Pharmaceuticals Incorporated | $26 |
| Boston Scientific Corporation | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-07-02
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140702001968 | I | Plastic And Reconstructive Surgery | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 46 | 39 | $0 |
| 15004 | Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less | 45 | 35 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 37 | 26 | $0 |
| 14301 | Repair of wound by transferring skin, 30.1-60.0 sq cm | 17 | 16 | $0 |
| 11900 | Injection into skin growth, 1-7 growths | 16 | 12 | $0 |
Insurance plans in this area (ZIP 60521)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL |
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