Healthcare Provider Details

I. General information

NPI: 1457217218
Provider Name (Legal Business Name): OPTUM MEDICAL CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2025
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3680 HILL BLVD
JEFFERSON VALLEY NY
10535-1500
US

IV. Provider business mailing address

PO BOX 95000-8363
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 914-245-7700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JONATHAN F NASSER
Title or Position: CEO
Credential: MD
Phone: 845-703-6999