Organization Active NPI

Optimal Professional Health Services PC

  • General Practice Physician
  • Norwood, MA
National Provider Identifier
1881059665
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
OPTIMAL PROFESSIONAL HEALTH SERVICES PC
Practice address
1418 Providence Hwy
Suite N
Norwood, MA 02062-4655
Phone
(617) 964-1440
Fax
(617) 964-7833
NPI assigned
Dec 22, 2015
Last updated
May 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Authorized official

Name
Joseph A Russo, MDNPI 1598732240
Title
Owner
Phone
(617) 364-1440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

1418 Providence Hwy
Suite N
Norwood, MA 02062-4655

Mailing address

944 Washington St
Suite One
South Easton, MA 02375-1177
Phone (508) 238-8646

Other identifiers 1

IdentifierTypeStateIssuer
110109264AMedicaidMA

National Provider Directory

National Provider Directory

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": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1881059665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 WASHINGTON ST",
            "address_2": "SUITE ONE",
            "city": "SOUTH EASTON",
            "state": "MA",
            "postal_code": "023751177",
            "telephone_number": "508-238-8646",
            "fax_number": "508-230-9772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 PROVIDENCE HWY",
            "address_2": "SUITE N",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020624655",
            "telephone_number": "617-964-1440",
            "fax_number": "617-964-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL PROFESSIONAL HEALTH SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-364-1440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110109264A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.