NPIMap

Individual provider Active NPI

Jose S De la Cruz, MD

  • Family Medicine Physician
  • Tigard, OR
National Provider Identifier
1003174285
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD189150 Issued in OR
Practice address
13200 SW Pacific Hwy
Tigard, OR 97223-4828
Phone
(503) 598-2000
Fax
(503) 639-0920
NPI assigned
Apr 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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 MD189150 OR Primary

Addresses

Primary practice location

13200 SW Pacific Hwy
Tigard, OR 97223-4828

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119

Other practice location 1

105 Arney Rd Ste 120
Woodburn, OR 97071-9472
Phone (503) 814-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20190402000609 OR Practitioner - Family Practice 2961649595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

13200 SW Pacific Hwy
Tigard, OR 97223-4828
Phone (503) 598-2000

Hospital & facility affiliations

  • Forest Park Healthcare at Home Hospice, Portland, OR, CCN 381570
  • Traditions Health Hospice, Portland, OR, CCN 381548
  • Assured Hospice Hospice, Portland, OR, CCN 381569
  • Gracious Care Hospice Hospice, Beaverton, OR, CCN 381575
  • Signature Healthcare at Home Hospice, Bend, OR, CCN 381580
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Praxis Health, PC Family Medicine CurrentSince Feb 1, 2020 Accepting new patients
Praxis Health, PC CurrentSince Feb 1, 2020 Accepting new patients
Uptown Providers Inc PastSince Aug 19, 2019 Accepting new patients

Locations

4510 SW Hall Blvd
Beaverton, OR 97005
Phone (503) 644-1171

6445 N Greeley Ave
Portland, OR 97217
Phone (503) 283-6607

13200 SW Pacific Hwy
Tigard, OR 97223
Phone (503) 598-2000

Interoperability endpoints

  • Direct secure messaging: jydelacruz@pacificmedicalgroup.directbygreenway.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Forest Park Healthcare at HomePortland, OR, CCN 381570 Hospice W-2 Managing Employee Jun 15, 2022
Traditions HealthPortland, OR, CCN 381548 Hospice Contracted Managing Employee Jan 17, 2025
Assured HospicePortland, OR, CCN 381569 Hospice W-2 Managing Employee Dec 22, 2021

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1003174285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13200 SW PACIFIC HWY",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972234828",
            "telephone_number": "503-598-2000",
            "fax_number": "503-639-0920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Arney Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Woodburn",
            "state": "OR",
            "postal_code": "970719472",
            "country_code": "US",
            "telephone_number": "503-814-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "JOSE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-25",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD189150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.