Optum Infusion Clinic, LLC

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

OPTUM INFUSION CLINIC, LLC

Practice address

20414 N 27TH Ave Ste 450
Phoenix, AZ 85027-0002

Phone

(913) 335-6786

Fax

(844) 855-0868

NPI assigned

Nov 29, 2023

Organization subpart

No

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

Authorized official

Name

Jeffrey Dallager

Title

Chief Financial Officer, Manager

Phone

(952) 205-7745

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Christian Taylor, FNP

  • Family Nurse Practitioner
  • Gilbert, AZ
  • NPI 1235098914
  NPD
• Peter Paul Moheb Hennis, AGNP

  • Gerontology Nurse Practitioner
  • Casa Grande, AZ
  • NPI 1588233175
  NPD (past)
• Brittany Summer Panico, DO

  • Rheumatology Physician
  • Gilbert, AZ
  • NPI 1811253677

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1891561999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15529 COLLEGE BLVD",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662191351",
            "telephone_number": "913-335-6786",
            "fax_number": "844-855-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20414 N 27TH AVE STE 450",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850270002",
            "telephone_number": "913-335-6786",
            "fax_number": "844-855-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM INFUSION CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-29",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "DALLAGER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER, MANAGER",
        "authorized_official_telephone_number": "952-205-7745"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optum Palliative and Hospice Care, Inc.
• Optum Pharmacy 801, Inc.
• Catherine Alaba Opuroku, LPN
• Oracle Industries I LTD
• Oraibi Care LLC

• Infusion Therapy Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Infusion Therapy Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.