NPIMap

Organization Active NPI

Optum Behavioral Care of Delaware, Inc

  • Counseling Psychologist
  • Wilmington, DE
National Provider Identifier
1326810086
Registry record updated Nov 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
3521 Silverside Rd Ste 2D
Wilmington, DE 19810-4900
Phone
(302) 268-6105
NPI assigned
Oct 26, 2023
Last updated
Nov 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 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 Psychologist 103TC1900X NU Primary

Addresses

Primary practice location

3521 Silverside Rd Ste 2D
Wilmington, DE 19810-4900

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240129001039 DE Part B Supplier - Clinic/Group Practice 4587017363 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Wilmington, DE

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.

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": "1698278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1326810086",
    "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": "3521 SILVERSIDE RD STE 2D",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104900",
            "telephone_number": "302-268-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM BEHAVIORAL CARE OF DELAWARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-26",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "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": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

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