Optimum Medical Group Inc.

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

OPTIMUM MEDICAL GROUP INC.

Practice address

2028 Liberty Rd Ste 201
Eldersburg, MD 21784-6980

Phone

(443) 537-0012

NPI assigned

Aug 15, 2024

Last updated

Aug 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Blessing Gabriel, CRNP

Title

Ceo

Phone

(443) 537-0012

Specialties & licenses 1

Addresses

Tax ID family

Optimum Medical Group Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Optimum Medical Group Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Gwynn Oak, MD
  • NPI 1407735749
  NPD tax ID
• Optimum Medical Group Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Columbia, MD
  • NPI 1871472118
  NPD tax ID

Locations

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1790517175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 STILLWATER RD",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 LIBERTY RD STE 201",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846980",
            "telephone_number": "443-537-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "BLESSING",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-537-0012",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optum Behavioral Care of North Carolina, PC
• Orthopaedic Associates of Central MD, PA
• Taylor Elizabeth Ortiz, LMSW
• Sharon C Owenga, NP
• Pamela A Pagano-Pickrel, D.O.

• Developmental Disabilities Clinic/Center in Eldersburg, MD
• Providers in Eldersburg, MD by specialty
• Developmental Disabilities Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.