NPIMap

Organization Active NPI

Optimal Orthopaedics PLLC

  • Pain Medicine Physician
  • Brookhaven, PA
National Provider Identifier
1326655267
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
OPTIMAL ORTHOPAEDICS PLLC
Practice address
3605 Edgmont Ave Ste a
Brookhaven, PA 19015-2862
Phone
(610) 876-6180
Fax
(610) 876-6130
NPI assigned
Sep 24, 2020
Last updated
Sep 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Authorized official

Name
Jason WeignerNPI 1063549756
Title
Owner
Phone
(610) 876-6180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X NU Primary

Addresses

Primary practice location

3605 Edgmont Ave Ste a
Brookhaven, PA 19015-2862

Mailing address

3605 Edgmont Ave Ste a
Brookhaven, PA 19015-2862
Phone (610) 876-6180

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220103002031 DE Part B Supplier - Clinic/Group Practice 2860883725 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Wilmington, DE

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1326655267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 EDGMONT AVE STE A",
            "city": "BROOKHAVEN",
            "state": "PA",
            "postal_code": "190152862",
            "telephone_number": "610-876-6180",
            "fax_number": "610-876-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 EDGMONT AVE STE A",
            "city": "BROOKHAVEN",
            "state": "PA",
            "postal_code": "190152862",
            "telephone_number": "610-876-6180",
            "fax_number": "610-876-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL ORTHOPAEDICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "WEIGNER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-876-6180"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.