Active NPI
Optimus Health Care Inc
- Federally Qualified Health Center (FQHC)
- Bridgeport, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- License
- 0073
- Legal business name
- OPTIMUS HEALTH CARE INC
- Practice address
- 471 Barnum Ave
Bridgeport, CT 06608-2409 - Phone
- (203) 576-3885
- Fax
- (203) 683-3620
- NPI assigned
- Feb 8, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ludwig Spinelli
- Title
- Chief Executive Officer
- Phone
- (203) 696-3260
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 0073 | CT | Primary |
Addresses
Primary practice location
471 Barnum Ave
Bridgeport, CT 06608-2409
Mailing address
982 E Main St
Bridgeport, CT 06608-1913
Phone (203) 696-3260
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C00383 | Other | CT | MEDICARE PART B |
| 004234788 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 9
Federally qualified health center certification: CCN 071837
- Legal name
- OPTIMUS HEALTH CARE INC
- Doing business as
- STAMFORD COMMUNITY HEALTH CENTER INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 7, 2008
- Last certification
- Mar 7, 2008
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Dec 9, 1976 in CT
- Enrollment address
- 1351 Washington Blvd
Stamford, CT 69022419
Federally qualified health center certification: CCN 071800
- Legal name
- OPTIMUS HEALTH CARE INC
- Doing business as
- LUDWIG M. SPINELLI BUILDING
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 1, 1991
- Last certification
- Oct 1, 1991
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Dec 9, 1976 in CT
- Enrollment address
- 471 Barnum Ave
Bridgeport, CT 66082409
Federally qualified health center certification: CCN 071810
- Legal name
- OPTIMUS HEALTH CARE INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 18, 1995
- Last certification
- Dec 18, 1995
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation
- Incorporated
- Dec 9, 1976 in CT
- Enrollment address
- 982 E Main St
Bridgeport, CT 66081913
Federally qualified health center certification: CCN 071811
- Legal name
- OPTIMUS HEALTH CARE INC
- Doing business as
- STRATFORD COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 18, 1995
- Last certification
- Dec 18, 1995
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation
- Incorporated
- Dec 9, 1976 in CT
- Enrollment address
- 305 Boston Ave
Stratford, CT 66145246
Federally qualified health center certification: CCN 071822
- Legal name
- OPTIMUS HEALTH CARE INC
- Doing business as
- STAMFORD COMMUNITY HEALTH CENTER INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 12, 2000
- Last certification
- Oct 12, 2000
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation
- Incorporated
- Dec 9, 1976 in CT
- Enrollment address
- 805 Atlantic St
Stamford, CT 69026805
Federally qualified health center certification: CCN 071885
- Legal name
- OPTIMUS HEALTH CARE INC
- Doing business as
- OPTIMUS WELLNESS CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 17, 2012
- Last certification
- Jan 17, 2012
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Dec 9, 1976 in CT
- Enrollment address
- 975 E Main St
Bridgeport, CT 66081914
Federally qualified health center certification: CCN 071880
- Legal name
- OPTIMUS HEALTH CARE INC
- Doing business as
- PARK CITY PRIMARY CARE CENTER INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 5, 2011
- Last certification
- Dec 5, 2011
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Dec 9, 1976 in CT
- Enrollment address
- 64 Black Rock Ave
Bridgeport, CT 66051200
Federally qualified health center certification: CCN 071891
- Legal name
- OPTIMUS HEALTH CARE INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 21, 2012
- Last certification
- Sep 21, 2012
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Dec 9, 1976 in CT
- Enrollment address
- 597 Pacific St
Stamford, CT 69025814
Other NPIs on the same Medicare enrollment 10
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Federally Qualified Health Center (FQHC)
- Stamford, CT
- NPI 1942574082
O20031105000254
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bridgeport, CT
- NPI 1992871875
O20080211000766, O20080214000244, O20080214000293, O20080304000508, O20080304000732, O20110928000645, O20110929000015, O20120802000008
-
- Federally Qualified Health Center (FQHC)
- Stamford, CT
- NPI 1164798138
O20031105000254
-
- Federally Qualified Health Center (FQHC)
- Bridgeport, CT
- NPI 1215207782
O20031105000254
-
- Federally Qualified Health Center (FQHC)
- Bridgeport, CT
- NPI 1346516317
O20031105000254, O20110928000645
-
- Federally Qualified Health Center (FQHC)
- Bridgeport, CT
- NPI 1659641363
O20031105000254, O20080214000293
-
- Federally Qualified Health Center (FQHC)
- Stamford, CT
- NPI 1780944736
O20031105000254, O20120802000008
-
- Federally Qualified Health Center (FQHC)
- Stratford, CT
- NPI 1922378496
O20080304000508
-
- Federally Qualified Health Center (FQHC)
- Bridgeport, CT
- NPI 1932479409
O20110929000015
-
- Federally Qualified Health Center (FQHC)
- Stamford, CT
- NPI 1467606087
O20080211000766
National Provider Directory
National Provider DirectoryLocations
975 E Main St
Bridgeport, CT 06608
Phone (203) 371-7111
3180 Main St
Ste G1
Bridgeport, CT 06606
Phone (203) 371-7111
982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260
3715 Main St
Ste 202
Bridgeport, CT 06606
Phone (203) 372-4636
82 George St
#88
Bridgeport, CT 06604
Phone (203) 576-3881
138 Stillwater Ave
Stamford, CT 06902
Phone (203) 357-0277
245 Selleck St
Stamford, CT 06902
Phone (203) 327-5111
8 Woodland Pl
Stamford, CT 06902
Phone (203) 348-4444
305 Boston Ave
Ste 209
Stratford, CT 06614
727 Honeyspot Rd
Stratford, CT 06615
Phone (203) 375-7242
Ownership & related parties
All disclosed owners & managing parties 16
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Colleen Ebankks-Shippey | Corporate Director | Jan 1, 2022 | |
| Corporate Director | Apr 10, 2017 | ||
| Bertcelis Morales | Corporate Director | Jan 1, 2022 | |
| Corporate Director | Apr 10, 2017 | ||
| Henry H Yoon | Corporate Director | Jan 1, 2022 | |
| Corporate Director | Jan 1, 2022 | ||
| Karen a Daley | Corporate Director | Jan 1, 2022 | |
| W-2 Managing Employee | Aug 1, 2021 | ||
| W-2 Managing Employee | Jan 1, 2022 | ||
| Corporate Director | Aug 1, 2021 | ||
| W-2 Managing Employee | Aug 1, 2021 | ||
| Carlos de la Iglesia | Corporate Director | Jan 1, 2022 | |
| Corporate Director | Apr 10, 2017 | ||
| Mack H Allen | Corporate Director | Jan 1, 2022 | |
| Corporate Director | Apr 10, 2017 | ||
| Mavina F Moore | Corporate Director | Mar 26, 2013 | |
| Edgar Rodriguez | Corporate Director | May 1, 2009 | |
| Lydia Martinez | Corporate Director | Apr 10, 2017 | |
| Julio I Carballo | Corporate Director | Oct 1, 2015 | |
| Cynthia Morales-Carr | Corporate Director | May 22, 2010 | |
| Colette Toni | Corporate Director | Apr 10, 2017 | |
| Mayra Cabanas | Corporate Director | Apr 10, 2017 | |
| Gejuan R Williams | Corporate Director | Aug 12, 2015 | |
| Timothy Bishop | Corporate Director | Nov 1, 2003 | |
| Katherine a Golar | Corporate Director | Mar 1, 2021 | |
| W-2 Managing Employee | Mar 1, 2021 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Bridgeport, CT
- NPI 1376608364
Corporate Director, W-2 Managing Employee
Practitioners & affiliated clinicians
Practitioners 184
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Social Worker
- New Britain, CT
- NPI 1801355219
-
- Obstetrics & Gynecology Physician
- Bridgeport, CT
- NPI 1497323562
-
- Internal Medicine Physician
- Danbury, CT
- NPI 1245278886
-
- Clinical Social Worker
- New Haven, CT
- NPI 1588272744
-
- Physician Assistant
- Bridgeport, CT
- NPI 1144547126
-
- Clinical Social Worker
- Bridgeport, CT
- NPI 1588379804
-
- Psychiatric/Mental Health Nurse Practitioner
- Bridgeport, CT
- NPI 1326018367
-
- Family Nurse Practitioner
- Bridgeport, CT
- NPI 1669109419
-
- Social Worker
- Stratford, CT
- NPI 1184465288
-
- Clinical Social Worker
- Stamford, CT
- NPI 1700158441
-
- Family Medicine Physician
- Stamford, CT
- NPI 1346261120
-
- Physician Assistant
- Bridgeport, CT
- NPI 1245647486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1461196800000",
"number": "1669445946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "982 E MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066081913",
"telephone_number": "203-696-3260",
"fax_number": "203-683-3620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "471 BARNUM AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066082409",
"telephone_number": "203-576-3885",
"fax_number": "203-683-3620"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OPTIMUS HEALTH CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-08",
"last_updated": "2016-04-21",
"status": "A",
"authorized_official_last_name": "SPINELLI",
"authorized_official_first_name": "LUDWIG",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "203-696-3260"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "CT",
"license": "0073",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART B",
"identifier": "C00383",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004234788",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.