NPIMap

Organization Active NPI

Optimum Staffing Services LLC

  • Home Health Agency
  • Brandon, FL
National Provider Identifier
1346984796
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
OPTIMUM STAFFING SERVICES LLC
Practice address
500 Vonderburg Dr Ste 205
Brandon, FL 33511-5964
Phone
(813) 655-4949
Fax
(813) 359-9270
NPI assigned
Apr 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Authorized official

Name
Gladys Kanodereka, RN
Title
Administrator, Owner
Phone
(813) 655-4949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

500 Vonderburg Dr Ste 205
Brandon, FL 33511-5964

Mailing address

500 Vonderburg Dr Ste 205
Brandon, FL 33511-5964
Phone (813) 655-4949

Other names 1

  • OPTIMUM HOME HEALTH AGENCY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230613003443 FL Part A Provider - Home Health Agency 3971961566 Practice locations: Brandon, FL

Home health agency certification: CCN 687271

Legal name
OPTIMUM STAFFING SERVICES LLC
Doing business as
OPTIMUM HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 28, 2023
Last certification
Oct 18, 2023
Organization structure
LLCProprietary
Incorporated
Jan 22, 2021 in FL
Enrollment address
500 Vonderburg Dr
Ste 205
Brandon, FL 33511-5964
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Optimum Home Health AgencyCCN 687271
Overall star rating
3 of 5
Ownership
-
Certified
Sep 28, 2023
Medicare certification status
ActiveFrom the Provider of Services file

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
10D2267638Optimum Home Health Agency500 Vonderburg Drive Suite 205, Brandon, FL 33511Certificate of waiverAug 28, 2026

National Provider Directory

National Provider Directory
Tax ID family
Optimum Home Health Agency5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

500 Vonderburg Dr
Ste 205
Brandon, FL 33511
Phone (813) 655-4949

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gladys Kanodereka Individual 5% Or Greater Direct Ownership InterestManager, Administrator Jan 7, 2021 50%
Corporate OfficerManager, Administrator Jan 7, 2021 50%
Corporate DirectorManager, Administrator Jan 7, 2021 50%
W-2 Managing EmployeeManager, Administrator Jan 7, 2021 50%
Valerie M Leishman Individual Corporate DirectorDirector of Nursing Oct 24, 2022
W-2 Managing EmployeeDirector of Nursing Oct 24, 2022
Samuel Mpondo Individual 5% Or Greater Direct Ownership InterestManager, Alt. Administrator Jan 7, 2021 50%
Corporate OfficerManager, Alt. Administrator Jan 7, 2021 50%
Corporate DirectorManager, Alt. Administrator Jan 7, 2021 50%
W-2 Managing EmployeeManager, Alt. Administrator Jan 7, 2021 50%

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1346984796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 VONDERBURG DR STE 205",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115964",
            "telephone_number": "813-655-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VONDERBURG DR STE 205",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115964",
            "telephone_number": "813-655-4949",
            "fax_number": "813-359-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM STAFFING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-22",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "KANODEREKA",
        "authorized_official_first_name": "GLADYS",
        "authorized_official_title_or_position": "ADMINISTRATOR, OWNER",
        "authorized_official_telephone_number": "813-655-4949",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OPTIMUM HOME HEALTH AGENCY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OPTIMUM HOME HEALTH AGENCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.