NPIMap

Organization Active NPI

Optumcare Colorado Medical Group LLC

  • Family Medicine Physician
  • Woodland Park, CO
National Provider Identifier
1467083741
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
Practice address
700 W US Highway 24
Woodland Park, CO 80863-8975
Phone
(719) 687-6022
Fax
(719) 687-6030
NPI assigned
Jan 27, 2020
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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

700 W US Highway 24
Woodland Park, CO 80863-8975

Mailing address

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

Other names 1

  • MOUNTAINVIEW MEDICAL GROUP PIKES PEAK 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
Tax ID family
Davita Med GRP Co Springs61 organizations share this tax ID, including this one
Part of
Davita Med GRP Co Springs

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

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": "1467083741",
    "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": "700 W US HIGHWAY 24",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808638975",
            "telephone_number": "719-687-6022",
            "fax_number": "719-687-6030"
        }
    ],
    "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNTAINVIEW MEDICAL GROUP PIKES PEAK",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MOUNTAINVIEW MEDICAL GROUP PIKES PEAK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodland Park, 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.