OPTUMCARE COLORADO MEDICAL GROUP LLC – NPI #1104242700
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

OPTUMCARE COLORADO MEDICAL GROUP LLC is a provider located in COLORADO SPRINGS, CO. NPPES has assigned the NPI number 1104242700 to OPTUMCARE COLORADO MEDICAL GROUP LLC on March 07, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The former legal business name for this organization is OPTUMCARE COLORADO SPRINGS LLC. The NPI data also shows multiple names associated with this provider such as Colorado Springs Health Partners LLC and 3 other listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was last updated on Aug 20, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for OPTUMCARE COLORADO MEDICAL GROUP LLC below.

NPI Profile for
OPTUMCARE COLORADO MEDICAL GROUP LLC

NPI Number
1104242700
Enumeration Date

(more than 12 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
OPTUMCARE COLORADO MEDICAL GROUP LLC
Former Legal Business Name: OPTUMCARE COLORADO SPRINGS LLC
Other name(s)
All associated names:
Former Legal Business Name
Colorado Springs Health Partners LLC
Former Legal Business Name
DaVita Medical Group Colorado Springs LLC
Doing Business As (dba)
Optum Colorado Springs - Roundhouse
Former Legal Business Name
OPTUMCARE COLORADO SPRINGS LLC
Primary location
600 S 21ST ST UNIT 100
COLORADO SPRINGS, CO 80904-3763
Phone: (719) 522-1133 Fax:
Mailing address
PO BOX 35380
LAS VEGAS, NV 89133-5380
Phone: (702) 579-3203 Fax: (719) 538-2997
Organization Subpart
No
Authorized Official
EMILY CASTILLO
ASSOCIATE DIRECTOR CREDENTIALING
Phone: (702) 579-3253
Updated
Certification Date
Aug 20, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for OPTUMCARE COLORADO MEDICAL GROUP LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidCO06085288
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
332900000X
- Non-Pharmacy Dispensing Site
CO
261QE0002X
- Clinic/Center / Emergency Care
CO
207R00000X
- Internal Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.