NPIMap

Organization Active NPI

Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Stamford, CT
National Provider Identifier
1780944736
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
0415 Issued in CT
Legal business name
OPTIMUS HEALTH CARE INC
Practice address
597 Pacific St
Stamford, CT 06902-5814
Phone
(203) 348-2792
Fax
(203) 327-2991
NPI assigned
May 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Authorized official

Name
Ludwig Spinelli
Title
Ceo
Phone
(203) 696-3260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 0415 CT Primary

Addresses

Primary practice location

597 Pacific St
Stamford, CT 06902-5814

Mailing address

982 E Main St
Bridgeport, CT 06608-1913
Phone (203) 696-3260

Other identifiers 2

IdentifierTypeStateIssuer
004234788MedicaidCT
C00383OtherCTMEDICARE PART B

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031105000254 CT Part B Supplier - Clinic/Group Practice 9335051580 Receives reassigned benefits from 149 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Stamford, CT; Stratford, CT; Milford, CT; Bridgeport, CT
O20120802000008 CT Part A Provider - Federally Qualified Health Center (FQHC) 9335051580 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Stamford, CT

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
CorporationNon-profit
Incorporated
Dec 9, 1976 in CT
Enrollment address
597 Pacific St
Stamford, CT 69025814

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

597 Pacific St
Stamford, CT 06902
Phone (203) 348-2792

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Karen a Daley Individual Corporate DirectorCeo Jan 1, 2022
W-2 Managing EmployeeCeo Aug 1, 2021

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1780944736",
    "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": "203-579-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 PACIFIC ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069025814",
            "telephone_number": "203-348-2792",
            "fax_number": "203-327-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUS HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "SPINELLI",
        "authorized_official_first_name": "LUDWIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-696-3260"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CT",
            "license": "0415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004234788",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "C00383",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.