Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Tara Lynn Ryan-Dedominicis

Individual provider Clinical Social Worker · NPI 1164192001

Dr. Tara Lynn Ryan-Dedominicis is a Clinical Social Worker in Bridgeport, Connecticut. Qualified in 2021, 5 years ago. Practices with Optimus Health Care Inc, a 77-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
5
Licensed in
CT
In the registry since
2021
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Practice location Address checks out

982 E Main St
Bridgeport, CT 06608-1913
Phone: (203) 696-3260
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 33 Overlook Ave, Basking Ridge, NJ 07920-2660 — (908) 334-6103

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 011683 (CT)

Record details

NPI number1164192001
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 13, 2021
Last updated in NPPESSeptember 13, 2021
Certification dateSeptember 13, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Optimus Health Care Inc — 77 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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