Mishelle Diane Andersen

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7523 Issued in CT

Practice address

64 Black Rock Ave
Bridgeport, CT 06605-1200

Phone

(203) 641-6110

NPI assigned

Jan 3, 2024

Last updated

Apr 3, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimus Health Care IncGroup PAC ID 9335051580, 79 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, CT
  • NPI 1669445946
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1063282853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BLACK ROCK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051200",
            "telephone_number": "203-641-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BLACK ROCK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051200",
            "telephone_number": "203-641-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "MISHELLE",
        "middle_name": "DIANE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "7523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anand & Anand M.D., LLP
• Nalini Anand, M.D.
• Nicole Marie Anastasio, DO
• Nidhi Anand Anchan, MD
• Alaina Andersen, LPC
• Angela Marie Anderson, MASTERS STUDENT
• Arthur James Anderson, LCSW, RN
• Michaela Colleen Anderson, PA-C
• Tiffany Lee Andino
• Miriam F Andrade, COTA

• Physician Assistant in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.