NPIMap

Organization Active NPI

Optimus Health Care

  • Dental Clinic/Center
  • Bridgeport, CT
National Provider Identifier
1669548376
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
0073 Issued in CT
Legal business name
OPTIMUS HEALTH CARE
Practice address
471 Barnum Ave
Bridgeport, CT 06608-2409
Phone
(203) 333-6864
Fax
(203) 332-0376
NPI assigned
Nov 27, 2006
Last updated
Jun 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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) 333-6864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 0073 CT Primary

Addresses

Primary practice location

471 Barnum Ave
Bridgeport, CT 06608-2409

Mailing address

471 Barnum Ave
Bridgeport, CT 06608-2409
Phone (203) 333-6864

Other identifiers 2

IdentifierTypeStateIssuer
004234770MedicaidCT
C00383OtherCTMEDICARE PART B C00383

National Provider Directory

National Provider Directory
Tax ID family
Optimus Health Care Inc5 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.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1669548376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 BARNUM AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066082409",
            "telephone_number": "203-333-6864",
            "fax_number": "203-332-0376"
        },
        {
            "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": "203-333-6864",
            "fax_number": "203-332-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUS HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "SPINELLI",
        "authorized_official_first_name": "LUDWIG",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "203-333-6864"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CT",
            "license": "0073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004234770",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B C00383",
            "identifier": "C00383",
            "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 Jun 22, 2010; 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.