NPIMap

Individual provider Active NPI

Cleopatra T Gordon-Pusey, M.D.

  • Family Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1821275462
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME99822 Issued in FL
Practice address
222 S Flamingo Rd
Pembroke Pines, FL 33027-1721
Phone
(954) 392-9026
Fax
(954) 357-2353
NPI assigned
Jan 25, 2008
Last updated
Jan 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME99822 FL Primary

Addresses

Primary practice location

222 S Flamingo Rd
Pembroke Pines, FL 33027-1721

Mailing address

PO Box 260816
Pembroke Pines, FL 33026-7816
Phone (954) 392-9026

Other identifiers 4

IdentifierTypeStateIssuer
146LMOtherFLBCBS
111851800MedicaidFL
101833800MedicaidFL
101833801MedicaidFL

Other names 1

  • Mrs. Cleopatra T Gordon-Pusey Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080731000620 FL Practitioner - Family Practice 8921172404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleopatra Gordon Pusey, MD P.a.Group PAC ID 6002946605, 4 clinicians

Practice addresses (Care Compare)

222 S Flamingo Rd
Pembroke Pines, FL 33027-1721
Phone (954) 392-9026

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cleopatra Gordon Pusey, MD P.a. Family Medicine CurrentSince Feb 10, 2010 Accepting new patients
Internal Medicine Associates & Specialties,Inc PastSince Sep 15, 2003 Accepting new patients

Locations

1100 S 56th Ave
Hollywood, FL 33023
Phone (954) 357-2353

222 S Flamingo Rd
Pembroke Pines, FL 33027
Phone (954) 392-9026

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1821275462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260816",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330267816",
            "telephone_number": "954-392-9026",
            "fax_number": "954-357-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271721",
            "telephone_number": "954-392-9026",
            "fax_number": "954-357-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON-PUSEY",
        "first_name": "CLEOPATRA",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME99822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "146LM",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111851800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101833800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101833801",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLEOPATRA",
            "last_name": "GORDON-PUSEY",
            "middle_name": "T",
            "prefix": "MRS.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.