MRS. AMY LOUISE BLOOMFIELD (PA) – Physician Assistant, NPI 1790976173
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for MRS. AMY LOUISE BLOOMFIELD (PA)
Memorial Hospital, 4500, Memorial Drive, Royal Heights, Belleville, Saint Clair County, Illinois, 62226, United States
MEMORIAL HOSPITAL MEDICAL AFFAIRS
BELLEVILLE, IL 62226
Phone: (618) 257-4644
Type: Mailing
4600, Memorial Drive, Royal Heights, Belleville, Saint Clair County, Illinois, 62226, United States
SUITE 120
BELLEVILLE, IL 622265368
Phone: (618) 257-4644
Type: Location
15740 S OUTER 40 RD
CHESTERFIELD, MO 630172004
Phone: (636) 735-4755
Fax: (636) 237-4133
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2025-11-12
PECOS data refreshed: 2026-05-27
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 |
|---|---|---|---|---|
| I20251112001317 | I | Physician Assistant | MO | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62226)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine, Internal Medicine | IL | |
| Emergency Medicine | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Physician Assistant | MO | |
| N E U R O L O G Y | AR | |
| Internal Medicine | MO |
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