OPTIMUS HEALTH CARE INC (NPI# 1932479409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932479409 |
| Entity Type | Organization |
| Organization Name | OPTIMUS HEALTH CARE INC |
| Other Organization Name | PARK CITY PRIMARY CARE CENTER |
| Practice Address |
64 Black Rock Ave Bridgeport CT 06605-1200 |
| Mailing Address |
982 E Main St Bridgeport CT 06608-1913 |
| Practice Telephone | 2035795000 |
| Practice Fax Number | 2033320376 |
| Mailing Telephone | 2036963260 |
| Mailing Fax Number | 2033320376 |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2011-12-30 |
| Authorized Official Name | LUDWIG SPINELLI (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2036963260 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
0388 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004234788 | 05 | |
| CT | MEDICARE PART B | C00383 | 01 |
| Other Name | Type Code |
|---|---|
| Park City Primary Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235485236 | Optimus Health Care Inc | Clinic/Center | 3180 Main St Ste G1, Bridgeport, CT 06606-4237 | 2012-07-27 |
| 1780944736 | Optimus Health Care Inc | Clinic/Center | 597 Pacific St, Stamford, CT 06902-5814 | 2012-05-24 |
| 1164798138 | Optimus Health Care Inc | Clinic/Center | 8 Woodland Pl, Stamford, CT 06902-6939 | 2012-03-23 |
| 1346516317 | Optimus Health Care Inc | Clinic/Center | 1071 E Main St, Bridgeport, CT 06608-1618 | 2012-03-23 |
| 1609142678 | Optimus Health Care Inc | Clinic/Center | 138 Stillwater Ave, Stamford, CT 06902-4843 | 2012-03-23 |
| 1073992764 | Optimus Health Care Inc | Clinic/Center | 949 Bridgeport Ave, Milford, CT 06460-3142 | 2015-05-27 |
| 1659641363 | Optimus Health Care Inc | Clinic/Center | 982 E Main St, Bridgeport, CT 06608-1913 | 2012-01-11 |
| 1215207782 | Optimus Health Care Inc | Clinic/Center | 82 George St, Bridgeport, CT 06604-3315 | 2011-12-30 |
| 1922378496 | Optimus Health Care Inc | Clinic/Center | 727 Honeyspot Rd, Stratford, CT 06615-7172 | 2011-12-30 |
| 1174893648 | Optimus Health Care Inc | Clinic/Center | 790 Central Ave, Bridgeport, CT 06607-1705 | 2011-12-30 |
| Street Address |
64 BLACK ROCK AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06605-1200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649269705 | Kris Kotsay | Dentist | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2005-10-20 |
| 1063942555 | Keitra Thompson | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2017-06-15 |
| 1497283295 | Jenifer Schmitz | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605 | 2017-05-24 |
| 1093256091 | Miriam Feinstein | Physician Assistant | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2017-03-10 |
| 1265828818 | Theresa Integral Dy Djama | Podiatrist | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2015-04-10 |
| 1154722403 | Marlene St Juste | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2014-09-05 |
| 1245647486 | Lissette I Cruz | Physician Assistant | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2014-07-21 |
| 1891123220 | Nicole Callagy | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2013-10-22 |
| 1063853638 | Aswani Daraboina | Internal Medicine | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2013-07-11 |
| 1912141136 | Luz Evelyn Omondi | Internal Medicine | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2009-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497312276 | Stacy-ann Thompson-grant | Social Worker | 170 Bennet T Street, Bridgeport, CT 06605 | 2019-05-28 |
| 1720502149 | Sheree Amankwah | Counselor | 170 Bennett Street, Bridgeport, CT 06605 | 2017-07-27 |
| 1417477324 | Aracelis Robertson | Case Manager/Care Coordinator | 1646 Fairfield Avenue, 3rd Floor, Bridgeport, CT 06605 | 2017-06-21 |
| 1699158170 | Cortney Davis | Physician Assistant | 3250 Fairfield Ave, Unit 217, Bridgeport, CT 06605 | 2015-07-02 |
| 1083020051 | Douglas Mccoy | Nurse Practitioner | 46 Albion St., Bridgeport, CT 06605 | 2014-07-10 |
| 1932513785 | Hallie Claire Riggs | Social Worker | 1730 State St Ext, Bridgeport, CT 06605 | 2014-06-19 |
| 1831518513 | Yvonne Booy | Counselor | 46 Albion Street, Bridgeport, CT 06605 | 2014-04-10 |
| 1760556955 | Joel W Allen | Obstetrics & Gynecology | 625 Clinton Ave, Bridgeport, CT 06605 | 2006-11-20 |
| 1316046428 | Allen P Schlein | Orthopaedic Surgery | 650 Clinten Avenue, Bridgeport, CT 06605 | 2006-09-22 |
| 1336127984 | Hancock Pharmacy | Pharmacy | 1557 Fairfield Ave, Bridgeport, CT 06605 | 2006-01-04 |
| Find all providers in zip 06605 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1669868931 | Community Care of West Virginia, Inc. | Clinic/Center | 413 Johnson Ave, Bridgeport, WV 26330-1309 | 2015-04-13 |
| 1326434846 | Community Care of West Virginia, Inc. | Clinic/Center | 515 Johnston Avenue, Bridgeport, WV 26330-1311 | 2015-04-10 |
| 1912392358 | Community Care of West Virginia, Inc. | Clinic/Center | 531 Johnson Ave, Bridgeport, WV 26330-1311 | 2015-04-02 |
| 1497176390 | Family Health Centers | Clinic/Center | 1015 Columbia Ave, Bridgeport, WA 98813 | 2013-12-18 |
| 1235485236 | Optimus Health Care Inc | Clinic/Center | 3180 Main St Ste G1, Bridgeport, CT 06606-4237 | 2012-07-27 |
| 1346516317 | Optimus Health Care Inc | Clinic/Center | 1071 E Main St, Bridgeport, CT 06608-1618 | 2012-03-23 |
| 1619348844 | Community Care of West Virginia, Inc. | Clinic/Center | 65 Professional Pl Ste 102103, Bridgeport, WV 26330-0258 | 2015-10-14 |
| 1659641363 | Optimus Health Care Inc | Clinic/Center | 982 E Main St, Bridgeport, CT 06608-1913 | 2012-01-11 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06605 |
Please comment or provide details below to improve the information on OPTIMUS HEALTH CARE INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.