NPIMap

Organization Active NPI

Bridges Community Support Services, Inc

  • Community/Behavioral Health Agency
  • Orlando, FL
National Provider Identifier
1043612344
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
0106165 Issued in FL
Legal business name
BRIDGES COMMUNITY SUPPORT SERVICES, INC
Practice address
5222 Andrus Ave Ste C
Orlando, FL 32810-5456
Phone
(407) 745-5022
Fax
(407) 601-4302
NPI assigned
Sep 18, 2014
Organization subpart
Yes
Parent organization
BRIDGES COMMUNITY SUPPORT SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Omusi RangerNPI 1548685118
Title
Ceo
Phone
(407) 745-5022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 0106165 FL Primary

Addresses

Primary practice location

5222 Andrus Ave Ste C
Orlando, FL 32810-5456

Mailing address

5222 Andrus Ave Ste C
Orlando, FL 32810-5456
Phone (407) 745-5022

Other practice location 1

750 S Orange Blossom Trl
Suite 229
Orlando, FL 32805-3118
Phone (407) 745-5022

Other identifiers 2

IdentifierTypeStateIssuer
013945100MedicaidFL
010616500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240529000767 FL Part B Supplier - Clinic/Group Practice 9638419476 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory
Part of
Bridges Community Support Services Inc

Locations

5222 Andrus Ave
Ste C
Orlando, FL 32810
Phone (407) 745-5020

750 S Orange Blossom Trl
Ste 229
Orlando, FL 32805
Phone (407) 683-2894

Networks

  • HealthSun Health Plans Network
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1043612344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5222 ANDRUS AVE STE C",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328105456",
            "telephone_number": "407-745-5022",
            "fax_number": "407-601-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5222 ANDRUS AVE STE C",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328105456",
            "telephone_number": "407-745-5022",
            "fax_number": "407-601-4302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 S Orange Blossom Trl",
            "address_2": "Suite 229",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328053118",
            "country_code": "US",
            "telephone_number": "407-745-5022",
            "fax_number": "407-601-4302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIDGES COMMUNITY SUPPORT SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIDGES COMMUNITY SUPPORT SERVICES, INC",
        "enumeration_date": "2014-09-18",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "RANGER",
        "authorized_official_first_name": "OMUSI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-745-5022"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "0106165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013945100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010616500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.