NPIMap

Organization Active NPI

Optima Health Plan

  • Family Medicine Physician
  • Norfolk, VA
National Provider Identifier
1396466066
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OPTIMA HEALTH PLAN
Practice address
824 N Military Hwy Ste 100
Norfolk, VA 23502-3652
Phone
(757) 233-4500
NPI assigned
Sep 9, 2022
Last updated
Sep 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Authorized official

Name
Doris Prince
Title
Director
Phone
(757) 983-5475

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X NU

Addresses

Primary practice location

824 N Military Hwy Ste 100
Norfolk, VA 23502-3652

Mailing address

PO Box 746550
Atlanta, GA 30374-6550
Phone (757) 233-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230504003199 VA Part B Supplier - Clinic/Group Practice 1658736186 Receives reassigned benefits from 16 practitioners
1 other NPI on this enrollment
Practice locations: Harrisonburg, VA; Norfolk, VA; Richmond, VA

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
Tax ID family
Optima Health Plan6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

5116 Richmond Henrico Tpke
Richmond, VA 23227
Phone (804) 332-5950

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1396466066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746550",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746550",
            "telephone_number": "757-233-4500",
            "fax_number": "757-252-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 N MILITARY HWY STE 100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023652",
            "telephone_number": "757-233-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMA HEALTH PLAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-983-5475"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.