CLEOPATRA C PARK N.P.
NPI 1194839852
Nurse Practitioner - Pediatrics in Phoenix, AZ

Q: What is Cleopatra Park's NPI number?

The NPI number for Cleopatra Park is 1194839852. It was assigned to this individual provider in the NPPES registry on August 19, 2006.

Q: What is Cleopatra Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Cleopatra Park was last updated on July 18, 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.

Active since August 19, 2006PECOS Enrolled

3864 N 27TH AVE, PHOENIX, AZ 85017(602) 685-6000(602) 212-6250 Get Directions Write a Review

NPPES record last updated: July 18, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 18, 2022, Oct 22, 2020, Oct 7, 2020 (3 updates tracked since 2020).

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About Cleopatra C Park N.p. NPPES

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

CLEOPATRA C PARK N.P. (NPI 1194839852) is an individual pediatrics provider in Phoenix, Arizona, licensed in Arizona (AP1818) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194839852

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameCLEOPATRA C PARKCredential: N.P.

Location Address3864 N 27TH AVEPhoenix, AZ 85017-4703

Mailing Address3003 N Central Ave Ste 400Phoenix, AZ 85012-2929 · (602) 685-6000 · Fax (602) 302-7925

Phone(602) 685-6000

Fax(602) 212-6250

Sole ProprietorNo

Enumeration DateAugust 19, 2006

Last NPPES UpdateJuly 18, 20223 updates tracked since enumeration

NPPES CertifiedJuly 18, 2022

✔ NPI 1194839852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in AZ · AP1818

Also ListedNurse PractitionerTaxonomy 363L00000X · License 076714 (AZ)

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License AP1818 (AZ)

3864 N 27TH AVE, Phoenix, AZ 85017

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Other Identifiers 1

Medicaid841264AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna HealthCare of Arizona, Inc, Oscar Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cleopatra C Park N.p. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Cleopatra Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Phoenix Children's Hospital

4.5 mi

Pediatrics

1919 E THOMAS RD
Phoenix, AZ 85016

Reassigned Medicare billing, Arizona enrollment
1,416 clinicians in this Medicare group

NPI 1922112044 (602) 933-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85017 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DR. HOLLY IRIS WILLIAMSON LISAC

Counselor (Addiction (Substance Use Disorder))