Stanley Wayne Blom, PH.D.
NPI 1538119912ActiveIndividual· Psychologist, Clinical· South Bend, IN
Opted out of Medicare from November 2019 to November 2027. Psychologist, Clinical (PH.D.) in South Bend, Indiana, licensed in IN, with an NPI issued in May 2006.
Overview
| NPI | 1538119912 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D. |
| Sole proprietor | Yes |
| NPI issued | May 10, 2006 |
| Last updated in NPPES | Aug 12, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 20040666A | IN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out Nov 1, 2019 – Nov 1, 2027 |
| Can order and refer | Yes |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
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