NPIMap

Organization Active NPI

Optimus Health Care

Doing business as Integrated Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Stamford, CT
National Provider Identifier
1942574082
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
0606 Issued in CT
Legal business name
OPTIMUS HEALTH CARE
Doing business as
Integrated Care Clinic
Practice address
780 Summer St
Stamford, CT 06901-1089
Phone
(203) 388-1611
Fax
(203) 388-1683
NPI assigned
Mar 7, 2012
Last updated
Mar 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 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 0606 CT Primary

Addresses

Primary practice location

780 Summer St
Stamford, CT 06901-1089

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
004234788MedicaidCT

Other names 1

  • Integrated Care Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1942574082",
    "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": "203-332-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 SUMMER ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069011089",
            "telephone_number": "203-388-1611",
            "fax_number": "203-388-1683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUS HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "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": "0606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004234788",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrated Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.