NPIMap

Organization Active NPI

Optimus Care Physician Services PLLC

  • Family Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1184006892
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME86524 Issued in FL
Legal business name
OPTIMUS CARE PHYSICIAN SERVICES PLLC
Practice address
5475 NW Saint James Dr # 148
Port St Lucie, FL 34983-3444
Phone
(772) 678-9033
NPI assigned
Jun 18, 2015
Last updated
Jun 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

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

Authorized official

Name
Magaly Rouzier, MDNPI 1659366060
Title
Owner
Phone
(772) 678-9033

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
Family Medicine Physician 207Q00000X ME86524 FL Primary

Addresses

Primary practice location

5475 NW Saint James Dr # 148
Port St Lucie, FL 34983-3444

Mailing address

5475 NW Saint James Dr # 148
Port St Lucie, FL 34983-3444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150811004354 FL Part B Supplier - Clinic/Group Practice 0840505525 Receives reassigned benefits from 10 practitioners
Practice locations: Port St Lucie, FL; Stuart, FL

National Provider Directory

National Provider Directory

Locations

5475 NW Saint James Dr
Port St Lucie, FL 34983
Phone (772) 678-9033

222 Purchase St
#109
Rye, NY 10580

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434672000000",
    "number": "1184006892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5475 NW SAINT JAMES DR # 148",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349833444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 NW SAINT JAMES DR # 148",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349833444",
            "telephone_number": "772-678-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUS CARE PHYSICIAN SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-19",
        "status": "A",
        "authorized_official_last_name": "ROUZIER",
        "authorized_official_first_name": "MAGALY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-678-9033",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME86524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; 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.