Optum Medical Services of California, P.C.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

OPTUM MEDICAL SERVICES OF CALIFORNIA, P.C.

Practice address

13625 Technology Dr
Eden Prairie, MN 55344-2252

Phone

(615) 224-5440

NPI assigned

Jan 30, 2015

Organization subpart

No

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

Authorized official

Name

James A Mittelberger, M.D.

Title

President

Phone

(612) 632-5372

Specialties & licenses 1

Addresses

Tax ID family

Optum Medical Services of California2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Optum Medical Services of California, PC

  • Nurse Practitioner
  • Baltimore, MD
  • NPI 1023484177
  NPD tax ID

Locations

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1528458486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13625 TECHNOLOGY DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553442252",
            "telephone_number": "615-224-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13625 TECHNOLOGY DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553442252",
            "telephone_number": "615-224-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM MEDICAL SERVICES OF CALIFORNIA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "MITTELBERGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-632-5372",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• One World Interpreting Inc
• Onsite Imaging and Speech Services
• Optima Homehealth LLC
• Optometric Associates, LTD.
• Optum Behavioral Care of Colorado, P.C.
• Optum Medical Services of Colorado, P.C.
• Optum Medical Services, P.C.
• Optum Medical Services, P.C.
• Optum Medical Services, PC
• Optumrx, Inc.

• Geriatric Medicine (Family Medicine) Physician in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Geriatric Medicine (Family Medicine) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.