OPTUM INFUSION SERVICES 202, INC. – Home Infusion Therapy Pharmacy, NPI 1700975802
Home Infusion Therapy Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for OPTUM INFUSION SERVICES 202, INC.
9655 FLORIDA MINING BLVD W STE 411
JACKSONVILLE, FL 322572041
Phone: (866) 680-5744
Fax: (844) 250-1991
Type: Location
1 OPTUM CIR STE 100
EDEN PRAIRIE, MN 553442956
Phone: (800) 328-5979
Type: Mailing
Florida Mining Boulevard West, Jacksonville, Duval County, Florida, 32257, United States
JACKSONVILLE, FL 32257
Phone: (866) 680-5744
Fax: (844) 250-1991
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-01-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-09-30 (618 days ago).
Enrollment records
3
Earliest due date
2024-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100930034688 | O | Pharmacy | FL | TBD |
| O20181128002938 | O | Pharmacy | FL | 2024-09-30 |
| O20210122000960 | O | Home Infusion Therapy Supplier | FL | 2026-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32257)
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