Active NPI
Optimum Healthcare Services LLC
- Home Health Agency
- Stoughton, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 LLC
- Ownership
- Proprietary
- Certified
- Jun 17, 2016
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D2075050 | Optimum Healthcare Services LLC | Certificate of waiver | Jul 29, 2026 |
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Kennedy Lee | 5% Or Greater Direct Ownership Interest | Dec 24, 2013 | 50% |
| Corporate Director | Dec 24, 2013 | 50% | |
| Adesuwa Lee | 5% Or Greater Direct Ownership Interest | Dec 24, 2013 | 50% |
| Corporate Director | Dec 24, 2013 | 50% | |
| W-2 Managing Employee | 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.
-
- Family Nurse Practitioner
- Medway, MA
- NPI 1134307572
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.