Organization Active NPI

Optimum Med Equipment Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Bayville, NY
National Provider Identifier
1770956096
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
OPTIMUM MED EQUIPMENT SUPPLY LLC
Practice address
10 Ludlam Ave
Bayville, NY 11709-3202
Phone
(516) 802-3738
NPI assigned
Nov 9, 2015
Last updated
Aug 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Authorized official

Name
Mrs. Marlene Montick
Title
Authorized Official
Phone
(516) 802-3738

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

10 Ludlam Ave
Bayville, NY 11709-3202

Mailing address

10 Ludlam Ave
Bayville, NY 11709-3202
Phone (516) 802-3738

National Provider Directory

National Provider Directory

Locations

10 Ludlam Ave
Bayville, NY 11709
Phone (516) 628-0525

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1770956096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LUDLAM AVE",
            "city": "BAYVILLE",
            "state": "NY",
            "postal_code": "117093202",
            "telephone_number": "516-802-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LUDLAM AVE",
            "city": "BAYVILLE",
            "state": "NY",
            "postal_code": "117093202",
            "telephone_number": "516-802-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM MED EQUIPMENT SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-09",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "MONTICK",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "516-802-3738",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; 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.