NPIMap

Organization Active NPI

Optum Behavioral Care of Delaware, Inc

  • Counseling Psychologist
  • Nashua, NH
National Provider Identifier
1043083595
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
OPTUM BEHAVIORAL CARE OF DELAWARE, INC
Practice address
1 Tara Blvd Ste 200
Nashua, NH 03062-2809
Phone
(603) 242-2296
NPI assigned
Nov 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kerry Biscornet
Title
Secretary
Phone
(603) 854-2929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

1 Tara Blvd Ste 200
Nashua, NH 03062-2809

Mailing address

11000 Optum Cir
Eden Prairie, MN 55344-2503
Phone (603) 854-2929

Other names 1

  • Family Counseling Associates of New Hampshire Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240208002713 NH Part B Supplier - Clinic/Group Practice 4587017363 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
Practice locations: Bedford, NH; Exeter, NH

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Springfield de Wilmington6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5840 Ellsworth Ave
Ste 104
Pittsburgh, PA 15232
Phone (412) 628-1326

969 Greentree Rd
Ste 145
Pittsburgh, PA 15220
Phone (412) 921-3908

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 44

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1043083595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 OPTUM CIR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553442503",
            "telephone_number": "603-854-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TARA BLVD STE 200",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030622809",
            "telephone_number": "603-242-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM BEHAVIORAL CARE OF DELAWARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "BISCORNET",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "603-854-2929"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Counseling Associates of New Hampshire",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nashua, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.