Optimus Health Care

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

00073 Issued in CT

Legal business name

OPTIMUS HEALTH CARE

Practice address

471 Barnum Ave
Bridgeport, CT 06608-2409

Phone

(203) 576-3885

Fax

(203) 332-0376

NPI assigned

Nov 24, 2006

Organization subpart

No

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

Authorized official

Name

Ludwig Spinelli

Title

Chief Executive Officer

Phone

(203) 696-3260

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT8 enrollments

Enrollment records 8

Federally qualified health center certification: CCN 071837

Legal name

OPTIMUS HEALTH CARE INC

Doing business as

STAMFORD COMMUNITY HEALTH CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 7, 2008

Last certification

Mar 7, 2008

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Dec 9, 1976 in CT

Enrollment address

1351 Washington Blvd
Stamford, CT 69022419

Federally qualified health center certification: CCN 071800

Legal name

OPTIMUS HEALTH CARE INC

Doing business as

LUDWIG M. SPINELLI BUILDING

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 1, 1991

Last certification

Oct 1, 1991

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Dec 9, 1976 in CT

Enrollment address

471 Barnum Ave
Bridgeport, CT 66082409

Federally qualified health center certification: CCN 071810

Legal name

OPTIMUS HEALTH CARE INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Dec 18, 1995

Last certification

Dec 18, 1995

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Dec 9, 1976 in CT

Enrollment address

982 E Main St
Bridgeport, CT 66081913

Federally qualified health center certification: CCN 071811

Legal name

OPTIMUS HEALTH CARE INC

Doing business as

STRATFORD COMMUNITY HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Dec 18, 1995

Last certification

Dec 18, 1995

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Dec 9, 1976 in CT

Enrollment address

305 Boston Ave
Stratford, CT 66145246

Federally qualified health center certification: CCN 071822

Legal name

OPTIMUS HEALTH CARE INC

Doing business as

STAMFORD COMMUNITY HEALTH CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 12, 2000

Last certification

Oct 12, 2000

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Dec 9, 1976 in CT

Enrollment address

805 Atlantic St
Stamford, CT 69026805

Federally qualified health center certification: CCN 071885

Legal name

OPTIMUS HEALTH CARE INC

Doing business as

OPTIMUS WELLNESS CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 17, 2012

Last certification

Jan 17, 2012

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Dec 9, 1976 in CT

Enrollment address

975 E Main St
Bridgeport, CT 66081914

Federally qualified health center certification: CCN 071880

Legal name

OPTIMUS HEALTH CARE INC

Doing business as

PARK CITY PRIMARY CARE CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Dec 5, 2011

Last certification

Dec 5, 2011

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Dec 9, 1976 in CT

Enrollment address

64 Black Rock Ave
Bridgeport, CT 66051200

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.

• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, CT
  • NPI 1346516317

  O20110928000645

  Same enrollment
• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, CT
  • NPI 1659641363

  O20080214000293

  Same enrollment
• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, CT
  • NPI 1669445946

  O20080211000766, O20080214000244, O20080214000293, O20080304000508, O20080304000732, O20110928000645, O20110929000015, O20120802000008

  Same enrollment
• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Stamford, CT
  • NPI 1780944736

  O20120802000008

  Same enrollment
• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Stratford, CT
  • NPI 1922378496

  O20080304000508

  Same enrollment
• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, CT
  • NPI 1932479409

  O20110929000015

  Same enrollment
• Optimus Health Care Inc.

  • Federally Qualified Health Center (FQHC)
  • Stamford, CT
  • NPI 1467606087

  O20080211000766

  Same enrollment

All disclosed owners & managing parties 16

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

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Katherine A Golar, MD

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1376608364

  Corporate Director, W-2 Managing Employee

  CMS ownership
• Henry Yoon, M.D.

  • Family Medicine Physician
  • Stamford, CT
  • NPI 1790786259

  Corporate Director

  CMS ownership

Practitioners 1

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

• Marleena Dimaggio, APRN

  • Nurse Practitioner
  • Fairfield, CT
  • NPI 1194727172
  NPD (past)

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1992871875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 BARNUM AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066082409",
            "telephone_number": "203-576-3885",
            "fax_number": "203-332-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 BARNUM AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066082409",
            "telephone_number": "203-576-3885",
            "fax_number": "203-332-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUS HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "SPINELLI",
        "authorized_official_first_name": "LUDWIG",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "203-696-3260"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "00073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  PART B",
            "identifier": "C00383",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235926",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Ernest Opalak, MD
• Miracle Chinonso Oparah, M.D.
• Roseberthe Opont
• Annabel Adwoa Marfoa Oppong
• Optimus Health Care
• Optimus Health Care Inc
• Optimus Health Care Inc
• Optimus Health Care Inc
• Optimus Health Care Inc
• Optimus Health Care Inc

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.