Optum Medical Care of New Jersey PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

OPTUM MEDICAL CARE OF NEW JERSEY PC

Practice address

264 Boyden Ave
Maplewood, NJ 07040-3070

Phone

(973) 761-5200

Fax

(973) 761-7617

NPI assigned

May 30, 2024

Organization subpart

Yes

Parent organization

OPTUM MEDICAL CARE OF NEW JERSEY PCAs reported in NPPES

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

Authorized official

Name

Gaurang Ravaji Brahmbhatt, MD

Title

Credentialing Supervisor

Phone

(201) 706-8490

Specialties & licenses 1

Addresses

Other names 1

• Riverside Medical Group Doing business as

Part of

Riverside Pediatric Group PC

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1508606237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARMON PLZ FL 10",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942803",
            "telephone_number": "551-220-4832",
            "fax_number": "551-257-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 BOYDEN AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403070",
            "telephone_number": "973-761-5200",
            "fax_number": "973-761-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM MEDICAL CARE OF NEW JERSEY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPTUM MEDICAL CARE OF NEW JERSEY PC",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "BRAHMBHATT",
        "authorized_official_first_name": "GAURANG",
        "authorized_official_middle_name": "RAVAJI",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "201-706-8490",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Ngozi Okorie, FNP-BC
• Georgeana Chinoyelum Okoro, RN, MSN, APN APPLICA
• Rachael Olubunmi Olaode, PMHNP
• Mary Chris Ong, MSW, LSW
• Optimum Health Care, LLC
• Organized Concepts, LLC
• Orion Healthcare LLC
• Pierre Arthur Oscar, ACSW, LCSW, MSW, MA
• Osha Data/Cih, Inc.
• Charity Osobi

• Durable Medical Equipment & Medical Supplies in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Durable Medical Equipment & Medical Supplies in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.