NPIMap

Organization Active NPI

Optumcare Colorado Medical Group, LLC

Doing business as ABC Pediatrics

  • Pediatrics Physician
  • Colorado Springs, CO
National Provider Identifier
1548891815
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
OPTUMCARE COLORADO MEDICAL GROUP, LLC
Doing business as
ABC Pediatrics
Practice address
8890 N Union Blvd Ste 220
Colorado Springs, CO 80920-2701
Phone
(719) 574-9191
Fax
(719) 574-2829
NPI assigned
Jan 27, 2020
Last updated
Mar 7, 2024By the provider in NPPES
Organization subpart
No

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

8890 N Union Blvd Ste 220
Colorado Springs, CO 80920-2701

Mailing address

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

Other names 2

  • ABC Pediatrics Doing business as
  • Optumcare Colorado Springs LLC Former legal business name

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0875286Optum Colorado - MVMG Abc Pediatrics8890 N Union Blvd, Suite 220, Colorado Springs, CO 80920Certificate of waiverApr 16, 2028

National Provider Directory

National Provider Directory
Tax ID family
Optumcare Colorado LLC61 organizations share this tax ID, including this one

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

Locations

2801 Youngfield St
Ste 150
Golden, CO 80401
Phone (303) 238-4277

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

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": "1548891815",
    "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": "8890 N UNION BLVD STE 220",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202701",
            "telephone_number": "719-574-9191",
            "fax_number": "719-574-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUMCARE COLORADO MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "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": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Optumcare Colorado Springs LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Colorado Springs, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.