Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Miss. Mishelle Diane Andersen

Individual provider Physician Assistant · NPI 1063282853

Miss. Mishelle Diane Andersen is a Physician Assistant in Bridgeport, Connecticut. Qualified in 2025, 1 year ago. Practices with Optimus Health Care Inc, a 77-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
1
Licensed in
CT
In the registry since
2024

Practice location Address checks out

64 Black Rock Ave
Bridgeport, CT 06605-1200
Phone: (203) 641-6110
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 7523 (CT)

Record details

NPI number1063282853
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 3, 2024
Last updated in NPPESApril 3, 2026
Certification dateApril 3, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Optimus Health Care Inc — 77 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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