NPIMap

Organization Active NPI

Optumcare Colorado Medical Group, LLC

Doing business as Monument Family Practice

  • Family Medicine Physician
  • Monument, CO
National Provider Identifier
1215568597
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OPTUMCARE COLORADO MEDICAL GROUP, LLC
Doing business as
Monument Family Practice
Practice address
550 W Highway 105
Monument, CO 80132-9122
Phone
(719) 488-9860
Fax
(719) 488-9868
NPI assigned
Jan 27, 2020
Last updated
Mar 7, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
OPTUMCARE COLORADO MEDICAL GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
David I Cohen
Title
Medical Director
Phone
(702) 480-2550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

550 W Highway 105
Monument, CO 80132-9122

Mailing address

2 S Cascade Ave Ste 140
Colorado Springs, CO 80903-1604
Phone (719) 538-2900

Other names 1

  • MONUMENT FAMILY PRACTICE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150129000413 CO Part B Supplier - Clinic/Group Practice 2769706431 Receives reassigned benefits from 386 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Littleton, CO; Evergreen, CO; Golden, CO; Highlands Ranch, CO; Lakewood, CO; Aurora, CO; Lone Tree, CO; Longmont, CO…

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory
Part of
Davita Medical Group Colorado Springs LLC

Locations

550 W Highway 105
Monument, CO 80132
Phone (719) 481-0161

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1215568597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S CASCADE AVE STE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031604",
            "telephone_number": "719-538-2900",
            "fax_number": "719-538-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W HIGHWAY 105",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801329122",
            "telephone_number": "719-488-9860",
            "fax_number": "719-488-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUMCARE COLORADO MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPTUMCARE COLORADO MEDICAL GROUP, LLC",
        "enumeration_date": "2020-01-27",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "702-480-2550"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MONUMENT FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MONUMENT FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monument, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.