Organization Active NPI

Optum Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Jericho, NY
National Provider Identifier
1285975797
Registry record updated May 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
OPTUM URGENT CARE, PLLC
Practice address
555 N Broadway
Jericho, NY 11753-2134
Phone
(516) 622-6000
NPI assigned
Mar 7, 2013
Last updated
May 6, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
PROHEALTH CARE ASSOCIATES LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2023

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

Authorized official

Name
Richard P. Morel, MD
Title
President
Phone
(516) 622-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NY Primary

Addresses

Primary practice location

555 N Broadway
Jericho, NY 11753-2134

Mailing address

1 Dakota Drive
Suite 320
New Hyde Park, NY 11042-1113
Phone (516) 622-6000

Other names 1

  • ProHealth Urgent Care, PLLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141017000598 NY Part B Supplier - Clinic/Group Practice 8628299518 Receives reassigned benefits from 516 practitioners
Practice locations: Huntington, NY; Huntington Station, NY; Little Neck, NY; Long Beach, NY; Massapequa Park, NY; New York, NY; Plainview, NY; Riverhead, NY…

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2069243Optum Urgent Care PLLC555 North Broadway, Jericho, NY 11753Certificate of waiverMay 31, 2027

National Provider Directory

National Provider Directory
Part of
Pro Healthcare Assoc LLP

Locations

148 Merrick Rd
Amityville, NY 11701
Phone (631) 789-2556

1049 Morris Park Ave
Bronx, NY 10461
Phone (929) 777-9082

10031 4th Ave
Brooklyn, NY 11209
Phone (218) 439-8200

330 Court St
Brooklyn, NY 11231
Phone (347) 335-0062

3448 Nostrand Ave
Brooklyn, NY 11229
Phone (347) 756-3410

6906 18th Ave
Brooklyn, NY 11204
Phone (718) 621-5933

833 Manhattan Ave
Brooklyn, NY 11222
Phone (347) 987-4040

129 W Sunrise Hwy
Freeport, NY 11520
Phone (516) 442-7090

25925 Union Tpke
Glen Oaks, NY 11004
Phone (718) 347-1470

16450 Crossbay Blvd
Howard Beach, NY 11414
Phone (718) 843-3366

16450 Crossbay Blvd
Fl 1
Howard Beach, NY 11414
Phone (718) 848-8412

247 Walt Whitman Rd
Huntington Station, NY 11746
Phone (631) 423-7400

4954 Merrick Rd
Massapequa Park, NY 11762
Phone (516) 308-7255

1 Dakota Dr
Ste 320
New Hyde Park, NY 11042

1601 3rd Ave
New York, NY 10128
Phone (212) 395-9000

1601 3rd Ave
Frnt 1
New York, NY 10128
Phone (646) 692-6272

291 3rd Ave
New York, NY 10010
Phone (212) 685-4849

1149 Old Country Rd
Riverhead, NY 11901
Phone (631) 727-3000

250 S Service Rd
Roslyn Heights, NY 11577
Phone (212) 277-6010

3894 Richmond Ave
Staten Island, NY 10312
Phone (347) 630-7985

7001 Amboy Rd
Staten Island, NY 10307
Phone (347) 838-6991

Practitioners & affiliated clinicians

Practitioners 645

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.

View all 645

NPI Registry JSON

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683331200000",
    "number": "1285975797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DAKOTA DRIVE",
            "address_2": "SUITE 320",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421113",
            "telephone_number": "516-622-6000",
            "fax_number": "516-622-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N BROADWAY",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532134",
            "telephone_number": "516-622-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM URGENT CARE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROHEALTH CARE ASSOCIATES LLP",
        "enumeration_date": "2013-03-07",
        "last_updated": "2023-05-06",
        "certification_date": "2023-05-06",
        "status": "A",
        "authorized_official_last_name": "MOREL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-622-6000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProHealth Urgent Care, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jericho, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.