Organization Active NPI

Valley Optimal Health, PC

  • Adult Mental Health Clinic/Center
  • Hadley, MA
National Provider Identifier
1326550435
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
50762 Issued in MA
Legal business name
VALLEY OPTIMAL HEALTH, PC
Practice address
8 River Dr
Hadley, MA 01035-3540
Phone
(413) 582-1839
Fax
(413) 582-6855
NPI assigned
Oct 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Authorized official

Name
Dr. Bruce I Goderez, MDNPI 1023165503
Title
Owner
Phone
(413) 582-1839

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
Adult Mental Health Clinic/Center 261QM0850X 50762 MA Primary

Addresses

Primary practice location

8 River Dr
Hadley, MA 01035-3540

Mailing address

PO Box 380
Hadley, MA 01035-0380
Phone (413) 582-1839

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171108000926 MA Part B Supplier - Clinic/Group Practice 7416213442 Receives reassigned benefits from 1 practitioner
Practice locations: Hadley, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1509321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1326550435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 380",
            "city": "HADLEY",
            "state": "MA",
            "postal_code": "010350380",
            "telephone_number": "413-582-1839",
            "fax_number": "413-582-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 RIVER DR",
            "city": "HADLEY",
            "state": "MA",
            "postal_code": "010353540",
            "telephone_number": "413-582-1839",
            "fax_number": "413-582-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY OPTIMAL HEALTH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-30",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "GODEREZ",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-582-1839",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MA",
            "license": "50762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hadley, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.