NPIMap

Organization Active NPI

Warner Family Practice, PC

Doing business as Optum Primary Care

  • Primary Care Clinic/Center
  • Chandler, AZ
National Provider Identifier
1649309816
Registry record updated Sep 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
1601 Issued in AZ
Legal business name
WARNER FAMILY PRACTICE, PC
Doing business as
Optum Primary Care
Practice address
2905 W Warner Rd
Suite 12
Chandler, AZ 85224-1674
Phone
(480) 831-8457
Fax
(480) 491-3112
NPI assigned
Mar 5, 2007
Last updated
Sep 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2023

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

Authorized official

Name
Emily Castillo
Title
Regional Manager
Phone
(702) 480-2550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 1601 AZ Primary

Addresses

Primary practice location

2905 W Warner Rd
Suite 12
Chandler, AZ 85224-1674

Mailing address

2905 W Warner Rd
Suite 12
Chandler, AZ 85224-1674
Phone (480) 831-8457

Other names 1

  • Optum Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000948 AZ Part B Supplier - Clinic/Group Practice 2769376342 Receives reassigned benefits from 10 practitioners
Practice locations: Chandler, AZ

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
03D0530708Optum Primary Care - Warner Rd2905 W Warner Rd Ste 12, Chandler, AZ 85224Certificate of waiverDec 12, 2027

National Provider Directory

National Provider Directory

Locations

2905 W Warner Rd
Ste 12
Chandler, AZ 85224
Phone (480) 831-8457

1611 E Warner Rd
Ste 4
Tempe, AZ 85284
Phone (602) 831-8457

Practitioners & affiliated clinicians

Practitioners 10

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": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693612800000",
    "number": "1649309816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 W WARNER RD",
            "address_2": "SUITE 12",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241674",
            "telephone_number": "480-831-8457",
            "fax_number": "480-491-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 W WARNER RD",
            "address_2": "SUITE 12",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241674",
            "telephone_number": "480-831-8457",
            "fax_number": "480-491-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARNER FAMILY PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2023-09-02",
        "certification_date": "2023-09-02",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "702-480-2550"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "1601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2023; 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.