Organization Active NPI

Optimum Healthcare Services LLC

  • Home Health Agency
  • Stoughton, MA
National Provider Identifier
1770905002
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
OPTIMUM HEALTHCARE SERVICES LLC
Practice address
6 Cabot PL Ste 8
Stoughton, MA 02072-4625
Phone
(781) 961-3320
Fax
(781) 961-3340
NPI assigned
Jan 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Authorized official

Name
Kennedy Lee
Title
Administrator
Phone
(781) 961-3320

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Custodial Care Facility 311Z00000X
Adult Care Home Facility 311ZA0620X

Addresses

Primary practice location

6 Cabot PL Ste 8
Stoughton, MA 02072-4625

Mailing address

6 Cabot PL Ste 8
Stoughton, MA 02072-4625
Phone (781) 961-3320

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140206000900 MA Part A Provider - Home Health Agency 4688803026 Practice locations: Stoughton, MA

Home health agency certification: CCN 227671

Legal name
OPTIMUM HEALTHCARE SERVICES LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 17, 2016
Last certification
Jun 17, 2016
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 24, 2013 in MA
Enrollment address
6 Cabot PL
Ste 8
Stoughton, MA 02072-4625

Care Compare: Home health agency

Medicare Care Compare
Listed as
Optimum Healthcare Services LLCCCN 227671
Ownership
Proprietary
Certified
Jun 17, 2016
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2075050Optimum Healthcare Services LLC6 Cabot Place, Stoughton, MA 02072Certificate of waiverJul 29, 2026

National Provider Directory

National Provider Directory

Locations

41 Highland Ave
#9
Randolph, MA 02368
Phone (781) 635-2005

6 Cabot Pl
Ste 8
Stoughton, MA 02072
Phone (781) 961-3320

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kennedy Lee Individual 5% Or Greater Direct Ownership Interest Dec 24, 2013 50%
Corporate DirectorDirector Dec 24, 2013 50%
Adesuwa Lee Individual 5% Or Greater Direct Ownership Interest Dec 24, 2013 50%
Corporate DirectorPresident Dec 24, 2013 50%
W-2 Managing EmployeePresident Ceo Dec 24, 2013 50%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1770905002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CABOT PL STE 8",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020724625",
            "telephone_number": "781-961-3320",
            "fax_number": "781-961-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CABOT PL STE 8",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020724625",
            "telephone_number": "781-961-3320",
            "fax_number": "781-961-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-06",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KENNEDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "781-961-3320"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, MA

Sources for this page

Verify at the official NPI Registry.