QUALITY MEDICAL CLINIC, LLC
NPI 1780288753
Family Medicine in Colorado Springs, CO
About Quality Medical Clinic, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
QUALITY MEDICAL CLINIC, LLC (NPI 1780288753) is a healthcare organization registered as a family medicine in Colorado Springs, Colorado and active in the NPI registry since November 2020. The organization holds a CLIA Waiver certificate valid through August 16, 2028 and lists Jason Yisu Park, Ceo/ President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Quality Medical Clinic, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Quality Medical Clinic, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Colorado Springs, CO 80917
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
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 06D2190592
Quality Medical Clinic · Colorado Springs, COFrequently 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 Quality Medical Clinic, LLC's NPI number?
The NPI number for Quality Medical Clinic, LLC is 1780288753. It was assigned to this organization in the NPPES registry on November 30, 2020.
Where is Quality Medical Clinic, LLC located?
Quality Medical Clinic, LLC is located at 3604 Galley Rd Ste 201, Colorado Springs, CO 80909. The listed phone number is (719) 638-4548.
What is Quality Medical Clinic, LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Quality Medical Clinic, LLC enrolled in Medicare?
Yes. Quality Medical Clinic, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Quality Medical Clinic, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Quality Medical Clinic, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Quality Medical Clinic, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 06D2190592) is associated with this NPI, valid through August 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Quality Medical Clinic, LLC was last updated on February 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Quality Medical Clinic, Llc · NPI 1780288753
Family Medicine organization in Colorado Springs, Colorado. Organization record, active in the CMS NPPES registry since November 30, 2020.
## Identity
- **NPI:** 1780288753 (Entity type: Organization)
- **Enumerated:** November 30, 2020
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Jason Park, CEO/ PRESIDENT
## Practice location
- **Address:** 3604 GALLEY RD STE 201, Colorado Springs, CO 80909-4301
- **Phone:** (719) 638-4548
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 17, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1780288753) · Data from the CMS NPPES public registry.