| Optimus Health Care Inc | |
|
471 Barnum Ave Bridgeport CT 06608-2409 | |
| (203) 576-3885 | |
| (203) 683-3620 |
| Full Name | Optimus Health Care Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 471 Barnum Ave, Bridgeport, Connecticut |
| Authorized Official Name and Position | Ludwig Spinelli (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2036963260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimus Health Care Inc 982 E Main St Bridgeport CT 06608-1913 Ph: (203) 696-3260 | Optimus Health Care Inc 471 Barnum Ave Bridgeport CT 06608-2409 Ph: (203) 576-3885 |
| NPI Number | 1669445946 |
|---|---|
| Provider Enumeration Date | 02/08/2006 |
| Last Update Date | 04/21/2016 |
| Medicare PECOS PAC ID | 9335051580 |
|---|---|
| Medicare Enrollment ID | O20031105000254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669445946 | NPI | - | NPPES |
| C00383 | Other | CT | MEDICARE PART B |
| 004234788 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 0073 (Connecticut) | Primary |
| Provider Name | Naureen Zafar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225178932 PECOS PAC ID: 5991607848 Enrollment ID: I20040122000456 |
| Provider Name | Enenge Abodjedi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952310666 PECOS PAC ID: 1254222110 Enrollment ID: I20040322001087 |
| Provider Name | Sudha Sreenivasan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942367800 PECOS PAC ID: 7012998974 Enrollment ID: I20040526001121 |
| Provider Name | Dora Bush |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811006398 PECOS PAC ID: 1153306824 Enrollment ID: I20040618000881 |
| Provider Name | Karana M Pierre |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1831194042 PECOS PAC ID: 5496715781 Enrollment ID: I20041012000659 |
| Provider Name | Patricia Marciano |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1245321025 PECOS PAC ID: 0244290849 Enrollment ID: I20041018001009 |
| Provider Name | Manuel J Rosales |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346348513 PECOS PAC ID: 5496718694 Enrollment ID: I20041109000454 |
| Provider Name | Forugh F Homayounrooz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346276912 PECOS PAC ID: 8123083755 Enrollment ID: I20041123000668 |
| Provider Name | Devra Sirot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114068962 PECOS PAC ID: 0648250167 Enrollment ID: I20050128000504 |
| Provider Name | Marleena Dimaggio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194727172 PECOS PAC ID: 9638124415 Enrollment ID: I20050315000123 |
| Provider Name | Dora Orosz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598798001 PECOS PAC ID: 3072544626 Enrollment ID: I20050824000366 |
| Provider Name | Shireen Donaldson-ramos |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275535346 PECOS PAC ID: 5698790566 Enrollment ID: I20051010000811 |
| Provider Name | Fern Blumenfeld-jaffe |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891778858 PECOS PAC ID: 0840213385 Enrollment ID: I20060110001011 |
| Provider Name | Susan R Glasman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1811906530 PECOS PAC ID: 2567471519 Enrollment ID: I20060419000404 |
| Provider Name | Anne Alexander Brewer |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1932118577 PECOS PAC ID: 3173629128 Enrollment ID: I20070508000237 |
| Provider Name | Joseph V Connelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346261120 PECOS PAC ID: 6901907872 Enrollment ID: I20070721000063 |
| Provider Name | Celeste S Cox-baldwin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922009588 PECOS PAC ID: 2264471747 Enrollment ID: I20070723000001 |
| Provider Name | Luis Rojas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487785838 PECOS PAC ID: 1850489287 Enrollment ID: I20071117000126 |
| Provider Name | Andrea J Adimando |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801936448 PECOS PAC ID: 9638252315 Enrollment ID: I20080219000414 |
| Provider Name | Joyce T Yang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801916903 PECOS PAC ID: 4789762550 Enrollment ID: I20080418000241 |
| Provider Name | Mary D Reilly |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1275542482 PECOS PAC ID: 6002985298 Enrollment ID: I20080514000148 |
| Provider Name | Stephanie L Wilborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366419251 PECOS PAC ID: 6406926856 Enrollment ID: I20080528000511 |
| Provider Name | Kenneth R Graham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245396266 PECOS PAC ID: 6103993050 Enrollment ID: I20080918000701 |
| Provider Name | Dionne Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427213958 PECOS PAC ID: 4880762897 Enrollment ID: I20081003000569 |
| Provider Name | Carissa A Tufano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760639819 PECOS PAC ID: 1850452087 Enrollment ID: I20081206000101 |
| Provider Name | Kirsten B Hohmann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912017989 PECOS PAC ID: 6507877586 Enrollment ID: I20081206000103 |
| Provider Name | Rebecca B Newman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548481740 PECOS PAC ID: 5395807812 Enrollment ID: I20081217000494 |
| Provider Name | Monika Kaul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154569200 PECOS PAC ID: 6901958214 Enrollment ID: I20090717000280 |
| Provider Name | Ann M Asunto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073747788 PECOS PAC ID: 7618022401 Enrollment ID: I20090831000374 |
| Provider Name | Vasundara Tummala |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659604528 PECOS PAC ID: 5698821908 Enrollment ID: I20090928000484 |
| Provider Name | Patricia V Blanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982837233 PECOS PAC ID: 9032256342 Enrollment ID: I20091019000582 |
| Provider Name | Raymond Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891794848 PECOS PAC ID: 2668500075 Enrollment ID: I20100505000730 |
| Provider Name | Iveliz Oramas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407178882 PECOS PAC ID: 4789712837 Enrollment ID: I20100511000169 |
| Provider Name | Norman Weinberger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659585313 PECOS PAC ID: 4082742994 Enrollment ID: I20100514000049 |
| Provider Name | Karin Michels Ashwood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922072644 PECOS PAC ID: 3476683004 Enrollment ID: I20100609000050 |
| Provider Name | Douglas P Olson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972788792 PECOS PAC ID: 3476685538 Enrollment ID: I20100726000177 |
| Provider Name | Debra Adler-klein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245278886 PECOS PAC ID: 4183725922 Enrollment ID: I20100819001215 |
| Provider Name | David John Lobo |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811968258 PECOS PAC ID: 4385760206 Enrollment ID: I20100929000277 |
| Provider Name | Deborah L Pinto |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629233036 PECOS PAC ID: 3779776794 Enrollment ID: I20101022000826 |
| Provider Name | Vicente A Diaz |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1114190154 PECOS PAC ID: 5092851188 Enrollment ID: I20101130000349 |
| Provider Name | Ellen Villasenor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538225107 PECOS PAC ID: 4587610738 Enrollment ID: I20110409000016 |
| Provider Name | Jose R Orellana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104845460 PECOS PAC ID: 2860599396 Enrollment ID: I20110617000116 |
| Provider Name | Esther M Mervil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023397510 PECOS PAC ID: 2567632144 Enrollment ID: I20110909002683 |
| Provider Name | Michelle L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780965525 PECOS PAC ID: 6800068636 Enrollment ID: I20111020000214 |
| Provider Name | Pamela A Rule |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033498845 PECOS PAC ID: 3476724592 Enrollment ID: I20111103000554 |
| Provider Name | Cheryl H Cottrol |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417091356 PECOS PAC ID: 8729171947 Enrollment ID: I20111114000208 |
| Provider Name | Paul J O Braonain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023013182 PECOS PAC ID: 0143121053 Enrollment ID: I20120315000659 |
| Provider Name | Rebecca Kaplan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275899346 PECOS PAC ID: 4082877477 Enrollment ID: I20120522001290 |
| Provider Name | Barry I Kerner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205059417 PECOS PAC ID: 7719146554 Enrollment ID: I20120524000416 |
| Provider Name | Manal Anz |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1285946426 PECOS PAC ID: 6406005115 Enrollment ID: I20121012000105 |
| Provider Name | Susan Fullerton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811168032 PECOS PAC ID: 6901056605 Enrollment ID: I20121015000281 |
| Provider Name | Randolph Ramirez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629178843 PECOS PAC ID: 7517118748 Enrollment ID: I20121115000195 |
| Provider Name | Lori Pelosi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649521352 PECOS PAC ID: 2668624578 Enrollment ID: I20121128000425 |
| Provider Name | Joanna R Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053675033 PECOS PAC ID: 0840444584 Enrollment ID: I20130206000201 |
| Provider Name | Luz E Omondi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912141136 PECOS PAC ID: 7719129113 Enrollment ID: I20130814000949 |
| Provider Name | Matthew Nwosu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073776563 PECOS PAC ID: 1456588037 Enrollment ID: I20131206000810 |
| Provider Name | Marcelyn C Molloy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053301358 PECOS PAC ID: 0143459321 Enrollment ID: I20140211000374 |
| Provider Name | Deena R Ebright |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346202371 PECOS PAC ID: 6002901998 Enrollment ID: I20140307000976 |
| Provider Name | Maribeth M Milne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689096588 PECOS PAC ID: 7719100486 Enrollment ID: I20140527001496 |
| Provider Name | Laura Burr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053323998 PECOS PAC ID: 5991928459 Enrollment ID: I20140602001339 |
| Provider Name | Shefali Ram Pathy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376682245 PECOS PAC ID: 3678796075 Enrollment ID: I20140603000271 |
| Provider Name | Elena D Dragoi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003962739 PECOS PAC ID: 3274755178 Enrollment ID: I20141110000281 |
| Provider Name | Virginie Le Dru Cohen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508269630 PECOS PAC ID: 5092937516 Enrollment ID: I20141117000691 |
| Provider Name | Kelly Bucci-didomenico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568795094 PECOS PAC ID: 0941522510 Enrollment ID: I20141210000532 |
| Provider Name | Nicole Abramowitz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245243922 PECOS PAC ID: 3072837525 Enrollment ID: I20150112000530 |
| Provider Name | Adrian C Demidont |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972692473 PECOS PAC ID: 8123032539 Enrollment ID: I20150318000735 |
| Provider Name | Sadee T Forde-cuffie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104177971 PECOS PAC ID: 1254568942 Enrollment ID: I20150408000659 |
| Provider Name | Renee C Casey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376734343 PECOS PAC ID: 4284952847 Enrollment ID: I20150410000062 |
| Provider Name | Paul J Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114164530 PECOS PAC ID: 0244541084 Enrollment ID: I20150619000430 |
| Provider Name | Letitia Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437582863 PECOS PAC ID: 4789996471 Enrollment ID: I20150709000858 |
| Provider Name | Danielle Moraes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922420330 PECOS PAC ID: 3678889508 Enrollment ID: I20150908002495 |
| Provider Name | Aikaterini Fineti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376855510 PECOS PAC ID: 2961717756 Enrollment ID: I20151123000065 |
| Provider Name | Setul R Pardanani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851471338 PECOS PAC ID: 9739071499 Enrollment ID: I20151201000077 |
| Provider Name | Catherine T Ford |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386642932 PECOS PAC ID: 4082913538 Enrollment ID: I20160504001702 |
| Provider Name | Yoberki Reyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629454780 PECOS PAC ID: 1052603222 Enrollment ID: I20160708000017 |
| Provider Name | Rosie Laurent |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295180107 PECOS PAC ID: 3476845231 Enrollment ID: I20160714001724 |
| Provider Name | Geovanna Fiallos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255717534 PECOS PAC ID: 2769789445 Enrollment ID: I20161128000526 |
| Provider Name | Helen Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700158441 PECOS PAC ID: 4284913740 Enrollment ID: I20161128001702 |
| Provider Name | Debra Gerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912069063 PECOS PAC ID: 4385639731 Enrollment ID: I20161212001822 |
| Provider Name | Claudette M Thyme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457731812 PECOS PAC ID: 5092096537 Enrollment ID: I20161221001643 |
| Provider Name | Cenita Cruz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871918532 PECOS PAC ID: 6800178484 Enrollment ID: I20170113001495 |
| Provider Name | Yolanda Amelia Briones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477869683 PECOS PAC ID: 1951685965 Enrollment ID: I20170310000504 |
| Provider Name | Kettly Cassamajor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235660267 PECOS PAC ID: 9638455827 Enrollment ID: I20170425001440 |
| Provider Name | Aswani Daraboina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063853638 PECOS PAC ID: 0941577241 Enrollment ID: I20170516002445 |
| Provider Name | Robert E O'sullivan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053751271 PECOS PAC ID: 5496024655 Enrollment ID: I20170630001374 |
| Provider Name | Kathryn Sigalow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063777035 PECOS PAC ID: 5799078325 Enrollment ID: I20170908001822 |
| Provider Name | Suelen Deoliveira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881140465 PECOS PAC ID: 2264710433 Enrollment ID: I20170919001449 |
| Provider Name | Mildred Hungria |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205131034 PECOS PAC ID: 1456625540 Enrollment ID: I20180118002735 |
| Provider Name | Annette Tirado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659590131 PECOS PAC ID: 8527320373 Enrollment ID: I20180315000993 |
| Provider Name | Shelly Chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629055736 PECOS PAC ID: 2466441175 Enrollment ID: I20180403001432 |
| Provider Name | Jenifer Schmitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497283295 PECOS PAC ID: 5395018246 Enrollment ID: I20180426002432 |
| Provider Name | Shel Swanson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1174970925 PECOS PAC ID: 9931464971 Enrollment ID: I20180523000260 |
| Provider Name | Dhaval S Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881033215 PECOS PAC ID: 4587941265 Enrollment ID: I20181120000492 |
| Provider Name | Nicholas Henry Fiebach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679669675 PECOS PAC ID: 8325947674 Enrollment ID: I20190125002659 |
| Provider Name | Keisha Clayton-fearon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891240776 PECOS PAC ID: 7517205446 Enrollment ID: I20190219000396 |
| Provider Name | Prim Wabunoha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750854402 PECOS PAC ID: 5496094468 Enrollment ID: I20190308002208 |
| Provider Name | Erin Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083171995 PECOS PAC ID: 0446591028 Enrollment ID: I20190409000148 |
| Provider Name | Liza Halper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063987808 PECOS PAC ID: 3870834906 Enrollment ID: I20190417002768 |
| Provider Name | Katherine A Golar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376608364 PECOS PAC ID: 9537309570 Enrollment ID: I20190502000672 |
| Provider Name | Theresa Villani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346410511 PECOS PAC ID: 1153491790 Enrollment ID: I20190618002515 |
| Provider Name | Lindsey Michel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093101826 PECOS PAC ID: 6709113475 Enrollment ID: I20190805001287 |
| Provider Name | Theresa Djama |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1265828818 PECOS PAC ID: 1557607488 Enrollment ID: I20190910001164 |
| Provider Name | Jessica Dinisco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629408596 PECOS PAC ID: 0941518450 Enrollment ID: I20190920000934 |
| Provider Name | Robert S Goldsmith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972686277 PECOS PAC ID: 8527398247 Enrollment ID: I20190924000553 |
| Provider Name | Jennifer E Kolakowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154889764 PECOS PAC ID: 3173854932 Enrollment ID: I20191008003341 |
| Provider Name | Jacqueline Gordon-hopwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669026126 PECOS PAC ID: 6305177528 Enrollment ID: I20191018001371 |
| Provider Name | Cassandra Aamodt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801355219 PECOS PAC ID: 6507291333 Enrollment ID: I20200123003151 |
| Provider Name | Gustavo D Herrera-brito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447898861 PECOS PAC ID: 0446687222 Enrollment ID: I20200218001581 |
| Provider Name | Patricia M Sliwinski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609293570 PECOS PAC ID: 2860763331 Enrollment ID: I20200327002862 |
| Provider Name | Sara M Franco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437700564 PECOS PAC ID: 3971933052 Enrollment ID: I20200414002399 |
| Provider Name | Shilpi Jain Aggarwal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992067367 PECOS PAC ID: 9436466851 Enrollment ID: I20200430002109 |
| Provider Name | Brianna Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003313339 PECOS PAC ID: 7012327216 Enrollment ID: I20201029000158 |
| Provider Name | Nnennaya Duke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992144190 PECOS PAC ID: 9638458219 Enrollment ID: I20201110002015 |
| Provider Name | Keitra Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063942555 PECOS PAC ID: 8527332022 Enrollment ID: I20201211000219 |
| Provider Name | Victoria Simeone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356827463 PECOS PAC ID: 3971918848 Enrollment ID: I20210227000053 |
| Provider Name | Lisamarie Indovina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568051043 PECOS PAC ID: 6406262971 Enrollment ID: I20210308001744 |
| Provider Name | Angela Avery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588272744 PECOS PAC ID: 8729497425 Enrollment ID: I20210510002647 |
| Provider Name | Carolyn Heins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447604202 PECOS PAC ID: 2163757568 Enrollment ID: I20210617000196 |
| Provider Name | Majdi Taher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346281193 PECOS PAC ID: 1951389279 Enrollment ID: I20210708002230 |
| Provider Name | Tammie C Carey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205398286 PECOS PAC ID: 6002140407 Enrollment ID: I20210812002352 |
| Provider Name | Angela Pereira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285796805 PECOS PAC ID: 3375553555 Enrollment ID: I20210901002357 |
| Provider Name | Cristina M Mallozzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700312451 PECOS PAC ID: 4981972122 Enrollment ID: I20210902002338 |
| Provider Name | Maria Del Mar Mazza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912524521 PECOS PAC ID: 8820495682 Enrollment ID: I20210921001652 |
| Provider Name | Tara Lynn Ryan-dedominicis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164192001 PECOS PAC ID: 4880092501 Enrollment ID: I20211011002994 |
| Provider Name | Gayle Paquin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154999431 PECOS PAC ID: 8628466679 Enrollment ID: I20211026000141 |
| Provider Name | Hyun S Kim |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1144617242 PECOS PAC ID: 1355731795 Enrollment ID: I20211129002566 |
| Provider Name | Wanda J Wicks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053477992 PECOS PAC ID: 3274517149 Enrollment ID: I20220404000292 |
| Provider Name | Noshaba Shahid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285126789 PECOS PAC ID: 7911381850 Enrollment ID: I20220826001245 |
| Provider Name | Kerry Milner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669109419 PECOS PAC ID: 0941677249 Enrollment ID: I20221028002294 |
| Provider Name | Luciana Vieira |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326339177 PECOS PAC ID: 9931458288 Enrollment ID: I20230504002255 |
| Provider Name | Ashley A Telesco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134821051 PECOS PAC ID: 1850756263 Enrollment ID: I20230508000585 |
| Provider Name | Katherine Vaillancourt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770112260 PECOS PAC ID: 8729441423 Enrollment ID: I20230829001043 |
| Provider Name | Carmen M Calder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326018367 PECOS PAC ID: 7214962133 Enrollment ID: I20231017000519 |
| Provider Name | Fikreta Cirikovic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932835634 PECOS PAC ID: 1759738651 Enrollment ID: I20231115000894 |
| Provider Name | Nicolas E Palacios Meza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518245638 PECOS PAC ID: 5597986240 Enrollment ID: I20240129003339 |
| Provider Name | Metehan Imamoglu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962066993 PECOS PAC ID: 2264768076 Enrollment ID: I20240214002112 |
| Provider Name | Julian Vallon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235692591 PECOS PAC ID: 2365886686 Enrollment ID: I20240214003531 |
Clinisanitas, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4543 Main St, Bridgeport, CT 06606 Phone: 305-921-7621 Fax: 305-921-7355 | |
Primed Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4699 Main St, Suite 105 Attn: Med3000, Bridgeport, CT 06606 Phone: 203-944-1940 Fax: 203-402-4196 | |
Afc Urgent Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4200 Main Street, Bridgeport, CT 06606 Phone: 203-916-5151 Fax: 203-916-5155 | |
Wellington Provider Group Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1000 Lafayette Blvd Ste 1100, Bridgeport, CT 06604 Phone: 859-518-8817 Fax: 859-201-1084 | |
Fairfield Clinical Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 978 E Main St, Bridgeport, CT 06608 Phone: 203-549-1872 | |
Ambulatory Services Bridgeport Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 267 Grant St, Bridgeport, CT 06610 Phone: 203-384-3000 | |
Ralphola Taylor Community Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 790 Central Ave, Bridgeport, CT 06607 Phone: 203-332-4567 Fax: 203-332-0376 |