Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Optumcare Colorado Medical Group LLC

Organization Family Medicine Physician · NPI 1104242700

Optumcare Colorado Medical Group LLC is a Family Medicine Physician in Colorado Springs, Colorado. Licensed in Colorado. Registered with an NPI since 2014.

Licensed in
CO
In the registry since
2014
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

600 S 21st St Unit 100
Colorado Springs, CO 80904-3763
Phone: (719) 522-1133
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Emergency Care Clinic/Center Taxonomy 261QE0002X (CO)
Non-Pharmacy Dispensing Site Taxonomy 332900000X (CO)

Record details

NPI number1104242700
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Emily Castillo — Associate Director Credentialing · (702) 579-3253
Other names Optum Colorado Springs - Roundhouse; Colorado Springs Health Partners Llc; Davita Medical Group Colorado Springs Llc; Optumcare Colorado Springs Llc
NPI enumeratedMarch 7, 2014
Last updated in NPPESAugust 20, 2024
Certification dateAugust 20, 2024
Mailing addressPo Box 35380, Las Vegas, NV 89133-5380

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