ALICE PARK MD
NPI 1891795076
Psychiatry & Neurology - Psychiatry in Stockton, CA
About Alice Park Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALICE PARK MD (NPI 1891795076) is an individual psychiatry provider in Stockton, California, licensed in Texas (L8157) and active in the NPI registry since July 2005. She is enrolled in Medicare PECOS and is a graduate of Other (1983).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Alice Park Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Alice Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Napa, CA 94558
- Reassigned Medicare billing, California enrollment
- 755 clinicians in this Medicare group
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 95210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Alice Park's NPI number?
The NPI number for Alice Park is 1891795076. It was assigned to this individual provider in the NPPES registry on July 28, 2005.
Where is Alice Park located?
Alice Park practices at 1305 Tommydon St, Stockton, CA 95210. The listed phone number is (209) 476-5200.
What is Alice Park's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.
Is Alice Park enrolled in Medicare?
Yes. Alice Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Alice Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Alice Park reassigns Medicare benefits to Department Of State Hospitals (Napa, CA). The 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 Alice Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Alice Park was last updated on December 27, 2021. 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.
# Alice Park, MD · NPI 1891795076
Psychiatry physician in Stockton, California. Individual provider, active in the CMS NPPES registry since July 28, 2005.
## Identity
- **NPI:** 1891795076 (Entity type: Individual)
- **Enumerated:** July 28, 2005
- **Primary specialty:** Psychiatry & Neurology - Psychiatry · taxonomy 2084P0800X
- **State license:** L8157 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 1305 TOMMYDON ST, Stockton, CA 95210-3364
- **Phone:** (209) 476-5200
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Department Of State Hospitals (NPI 1326098161, Napa, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1983
## Record status
- **NPPES last updated:** December 27, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1891795076) · Data from the CMS NPPES public registry.