Organization Active NPI

Optimo Physician Associates

  • Internal Medicine Physician
  • Sewell, NJ
National Provider Identifier
1619294170
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05828000 Issued in NJ
Legal business name
OPTIMO PHYSICIAN ASSOCIATES
Practice address
438 Ganttown Rd
Suite B-1
Sewell, NJ 08080-2341
Phone
(609) 744-4555
Fax
(856) 258-4557
NPI assigned
Apr 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Authorized official

Name
Joseph Anthony Libby, M.D.
Title
Owner
Phone
(609) 744-4555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA05828000 NJ Primary

Addresses

Primary practice location

438 Ganttown Rd
Suite B-1
Sewell, NJ 08080-2341

Mailing address

438 Ganttown Rd
Suite B-1
Sewell, NJ 08080-2341
Phone (609) 744-4555

National Provider Directory

National Provider Directory

Locations

438 Ganttown Rd
Ste B1
Sewell, NJ 08080
Phone (856) 270-2053

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1619294170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 GANTTOWN RD",
            "address_2": "SUITE B-1",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802341",
            "telephone_number": "609-744-4555",
            "fax_number": "856-258-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 GANTTOWN RD",
            "address_2": "SUITE B-1",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802341",
            "telephone_number": "609-744-4555",
            "fax_number": "856-258-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMO PHYSICIAN ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "LIBBY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-744-4555",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05828000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.