Utica Park Clinic – Family Medicine Physician, NPI 1235182775

Utica Park Clinic is a healthcare provider. based in Tulsa, Oklahoma. specializing in Family Medicine Physician. The NPI Number for Utica Park Clinic is 1235182775

Main info

Organization
Name
Utica Park Clinic
NPI
1235182775
Phone
(918) 579-3627
Address
1145 S UTICA AVE
Authorized Official
STEPHEN C. PETROVICH EVP GENERAL COUNSEL
Enumeration Date
18 May 2006
Last Update Date
6 April 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness90
Years active:20State licenses:0Digital endpoints

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Provider Addresses for Utica Park Clinic

  • Hillcrest Medical Group, 1145, South Utica Avenue, Midtown Terrace, Tulsa, Tulsa County, Oklahoma, 74104, United States

    SUITE 110

    TULSA, OK 741044000

    Phone: (918) 579-3627

    Type: Mailing

  • 340 SEVEN SPRINGS WAY STE 100

    BRENTWOOD, TN 370275697

    Phone: (615) 296-3594

    Type: Mailing

  • 1120 S UTICA AVE STE 100

    TULSA, OK 741044012

    Phone: (918) 579-3826

    Fax: (918) 579-1262

    Type: Location

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: 2004-08-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-03-31 (70 days ago).

Enrollment records

1

Earliest due date

2026-03-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040817001197OClinic/Group PracticeOK2026-03-31

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.

Verify on CMS Revalidation Lookup Tool

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 74104)

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Reviews

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Frequently asked questions

What identifier follows Utica Park Clinic across health systems?
The NPI 1235182775 uniquely identifies Utica Park Clinic in U.S. healthcare data.
Should I treat Utica Park Clinic as an active provider?
Patients and plans typically see Utica Park Clinic as active in the national extract.
Which specialty label fits Utica Park Clinic?
NPPES ties Utica Park Clinic to Family Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Utica Park Clinic tied to Tulsa, Oklahoma?
If you are local to Tulsa, Oklahoma, Utica Park Clinic may be relevant to your search.
Who maintains Utica Park Clinic's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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