Organization · Type 2 NPI

Optumcare Colorado Medical Group LLC

General Practice Physician · Colorado Springs, CO

NPI number 1063955425 Active

Practice location

2405 Research Pkwy
Colorado Springs, CO 80920-1044

Call (719) 268-2800 Map

Fax (719) 268-2824

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Internal Medicine Physician	207R00000X	None listed
General Practice Physician Primary	208D00000X	None listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

18 other providers at this address

Other general practice physician providers in Colorado Springs

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NPI record

NPI: 1063955425
Entity type: Organization (Type 2)
Issued: Dec 2, 2016
Last updated: Aug 20, 2024
Status: Active

Other names

<unavail>
Optum Colorado Springs - Briargate · doing business as
Colorado Springs Health Partners LLC · former legal business name
Davita Medical Group Colorado Springs LLC · former legal business name
Optumcare Colorado Springs LLC · former legal business name

Authorized official

Emily Castillo
Assoc Director Credentialing
(702) 579-3253

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1063955425

Optumcare Colorado Medical Group LLC's National Provider Identifier is 1063955425, issued on Dec 2, 2016. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Colorado Springs, CO. The record was last updated on Aug 20, 2024.