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OPTUM
NPI 1063143907
Family Medicine in Overland Park, KS

Active since June 21, 2022CLIA Certified · 4 labs
6860 W 115TH ST, OVERLAND PARK, KS 66211(913) 253-0601 Get Directions Write a Review

NPPES record last updated: October 27, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 27, 2023, Jul 25, 2023 (2 updates tracked since 2023).

About Optum NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OPTUM (NPI 1063143907) is a healthcare organization registered as a family medicine in Overland Park, Kansas and active in the NPI registry since June 2022. The organization holds 4 active CLIA laboratory certificates and lists Emily Castillo, Medical Staff Manager, as its authorized official.

NPPES Registry Identity

NPI1063143907
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameOPTUM MEDICAL GROUP P A
Location Address6860 W 115TH STOverland Park, KS 66211-2457
Mailing AddressPo Box 35380Las Vegas, NV 89133-5380 · (702) 579-3253
Phone(913) 253-0601
Organization SubpartNo
Authorized OfficialEmily CastilloMedical Staff Manager · (702) 480-2550
Enumeration DateJune 21, 2022
Last NPPES UpdateOctober 27, 20232 updates tracked since enumeration
NPPES CertifiedOctober 27, 2023
✔ NPI 1063143907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

6860 W 115TH ST, Overland Park, KS 66211
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Other Names 1

Doing Business AsOptum

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 29D2076573

Optumcare Primary Care-Del Webb · Las Vegas, NV
Active · expires Apr 21, 2028
CLIA Number29D2076573
Laboratory TypePhysician Office
Certificate Effective DateApril 22, 2026
Certificate Expiration DateApril 21, 2028
Laboratory DirectorVictor M. Muro
Laboratory Phone(702) 724-8880
Laboratory LocationOptumcare Primary Care-Del Webb8526 Del Webb Blvd, Las Vegas, NV 89134
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 29D2126282

Optum Pulmonology · Las Vegas, NV
Active · expires Mar 11, 2028
CLIA Number29D2126282
Laboratory TypePhysician Office
Certificate Effective DateMarch 12, 2026
Certificate Expiration DateMarch 11, 2028
Laboratory DirectorRobert M Lampert
Laboratory Phone(702) 724-8844
Laboratory LocationOptum Pulmonology4750 Oakey Blvd Fl 2, Las Vegas, NV 89102
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 29D2125370

Optumcare Cancer Care-W Charleston · Las Vegas, NV
Active · expires Jun 25, 2027
CLIA Number29D2125370
Laboratory TypePhysician Office
Certificate Effective DateJune 26, 2025
Certificate Expiration DateJune 25, 2027
Laboratory DirectorRussell P. Gollard
Laboratory Phone(702) 824-8787
Laboratory LocationOptumcare Cancer Care-W Charleston2300 W Charleston, Las Vegas, NV 89102
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 29D2167600

Optumcare Cancer Care-W Charleston Nuclear Med · Las Vegas, NV
Active · expires Jun 10, 2027
CLIA Number29D2167600
Laboratory TypePhysician Office
Certificate Effective DateJune 11, 2025
Certificate Expiration DateJune 10, 2027
Laboratory DirectorRussell P. Gollard
Laboratory Phone(702) 724-8787
Laboratory LocationOptumcare Cancer Care-W Charleston Nuclear Med2300 W Charleston Blvd, Las Vegas, NV 89102
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. THOMAS PATRICK BREMYER R.PH.
Pharmacist
6860 W 115TH ST
OVERLAND PARK, KS 66211
Johnson County (866) 218-7398
OPTUM MEDICAL SERVICES, PC
Family Medicine
6860 W 115TH ST, OVERLAND PARK INTERNATIONAL TRADE
OVERLAND PARK, KS 66211
Johnson County (800) 645-9656
MRS. CAMILLE DENISE ALUMBAUGH RPH
Pharmacist
6860 W 115TH ST
OVERLAND PARK, KS 66211
Johnson County (620) 694-6563
SHIANNE WILLIAMS
Physician Assistant
6860 W 115TH ST
OVERLAND PARK, KS 66211
Johnson County (702) 579-3203
HOLLY BREWER N.P.
Nurse Practitioner (Family)
6860 W 115TH ST
OVERLAND PARK, KS 66211
Johnson County (877) 620-6194
MEDEXPRESS PRIMARY CARE KANSAS, P.A.
General Practice
6860 W 115TH ST
OVERLAND PARK, KS 66211
Johnson County (913) 661-7181
DENNIS M. JENSEN MD
Family Medicine
6860 W 115TH ST
OVERLAND PARK, KS 66211
Johnson County (843) 632-2293
LESLYN QUICK BROUILLETTE NP
Nurse Practitioner (Adult Health)
6860 W 115TH ST
OVERLAND PARK, KS 66211
Johnson County (816) 799-4135

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Optum Medical Group P A's NPI number?

The NPI number for Optum Medical Group P A is 1063143907. It was assigned to this organization in the NPPES registry on June 21, 2022. The provider is doing business as Optum.

Where is Optum Medical Group P A located?

Optum Medical Group P A is located at 6860 W 115th St, Overland Park, KS 66211. The listed phone number is (913) 253-0601.

What is Optum Medical Group P A's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Optum Medical Group P A hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Optum Medical Group P A was last updated on October 27, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.