Optimal Mens Center PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OPTIMAL MENS CENTER PLLC

Practice address

700 N Estrella Pkwy Ste 145
Goodyear, AZ 85338-9329

Phone

(602) 678-4625

NPI assigned

Dec 19, 2019

Organization subpart

No

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

Authorized official

Name

Kerry Knight, PANPI 1194730762

Title

Partner

Phone

(623) 640-4973

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20695/brand/1/csg/1/fhir/r4

Practitioners 8

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

• Kerry M Knight, PAC

  • Physician Assistant
  • Litchfield Park, AZ
  • NPI 1194730762
  Medicare reassignment Care Compare group Authorized official
• Cynthia Dianne Reed, D.O.

  • Family Medicine Physician
  • Goodyear, AZ
  • NPI 1750585782
  Medicare reassignment Care Compare group NPD
• Trent Wilson Knight, PA

  • Physician Assistant
  • Goodyear, AZ
  • NPI 1366695470
  Medicare reassignment Care Compare group
• Boris Boguslavskiy, NP

  • Adult Health Nurse Practitioner
  • Gilbert, AZ
  • NPI 1689075509
  Medicare reassignment NPD
• Nasser Hajaig, MD

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1457324204

  Family Medicine

  Medicare reassignment NPD
• Ran McBryde, APN

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1841760766
  Medicare reassignment NPD
• Mitzi Schardt, MSN NP

  • Nurse Practitioner
  • Fort Myers, FL
  • NPI 1821267816

  AZ

  Medicare reassignment NPD
• George Anthony Fuzfa, PA-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1609063247
  NPD (past)

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1811535974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N ESTRELLA PKWY STE 145",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N ESTRELLA PKWY STE 145",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389329",
            "telephone_number": "602-678-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL MENS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "623-640-4973",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omnia Women'S Health Center, PLLC
• Amy Ong
• Ashley Ong
• Gloria Ong, MD
• Optimal Health and Wellness Center PLLC
• Orofacial Pain Center, PC
• Leonel Ortiz, PTA
• Quentin Ortiz, CRNA
• Robert Mushelovich Osipov, M.D
• Salah Osman

• Family Medicine Physician in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.