JILL C BLOOMER (RN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1073135869

JILL C BLOOMER (RN) is a healthcare provider. based in Duluth, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials RN. They hold a License No. 308022 (NC). The NPI Number for JILL C BLOOMER (RN) is 1073135869

Main info

Female
5 Years Of Experience
Name
JILL C BLOOMER (RN)
NPI
1073135869
Phone
(907) 854-6005
Address
101 W 2ND ST
Enumeration Date
14 May 2020
Last Update Date
8 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2183108896
Graduation Year
2021 (5 years ago)
PAC ID
3678970985
Group Practice PAC ID
2163767286
Professional Enrollment ID
I20210928003396
Address ID
MN557201631CL1001XBXXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:6State licenses:2Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for JILL C BLOOMER (RN)

  • 101 W 2ND ST

    DULUTH, MN 558022086

    Phone: (907) 854-6005

    Type: Mailing

  • 615 SUMMIT ST

    CARTHAGE, NC 283274002

    Phone: (907) 854-6005

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $133.

Total Amount is formed as General ($133) + Research ($0) + Ownership ($0) = $133.

Last reported payment date: 2024-08-13 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($49).

Total Amount

$133

General + Research + Ownership

Payments

9

Total payment records

General Amount

$133

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2021-09-28

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210928003396INurse PractitionerMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90833Psychotherapy with evaluation and management visit, 30 minutes4019$0
99214Established patient office or other outpatient visit, 30-39 minutes4019$0
View full utilization report →

Insurance plans in this area (ZIP 55802)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163767286View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Nurse PractitionerMN
Nurse PractitionerWI
Mental Health CounselorMN

Reviews

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Frequently asked questions

Can I cross-check JILL C BLOOMER (RN) using NPI 1073135869?
NPI 1073135869 belongs to JILL C BLOOMER (RN); compare other details if you need extra assurance.
Is there an active status for JILL C BLOOMER (RN)?
For scheduling context, JILL C BLOOMER (RN) is shown as active in the registry.
How would a patient describe JILL C BLOOMER (RN)'s focus?
For JILL C BLOOMER (RN), the primary taxonomy reads as Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with JILL C BLOOMER (RN)?
Directory geography for JILL C BLOOMER (RN) centers on Duluth, Minnesota.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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