Individual provider Active NPI

Pablito Dela Cruz, M.D.

  • Pediatrics Physician
  • Terre Haute, IN
National Provider Identifier
1003870791
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01059798 Issued in IN
Practice address
1310 E Davis Dr
Terre Haute, IN 47802-4034
Phone
(812) 232-7337
Fax
(812) 232-7338
NPI assigned
Apr 12, 2006
Last updated
Dec 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01059798 IN Primary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 01059798A IN

Addresses

Primary practice location

1310 E Davis Dr
Terre Haute, IN 47802-4034

Mailing address

1310 E Davis Dr
Terre Haute, IN 47802-4034
Phone (812) 232-7337

Other identifiers 1

IdentifierTypeStateIssuer
200507050MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
243NYMDAcupuncturist
01059798AINMDNeurology with Special Qualifications in Child Neurology Physician
000243NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital Inc. Current Accepting new patients
Major Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pablito.dela-cruz.1@26578.direct.athenahealth.com
  • Direct secure messaging: pdelacruz@unionhealth.cernerdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1003870791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 E DAVIS DR",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024034",
            "telephone_number": "812-232-7337",
            "fax_number": "812-232-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 E DAVIS DR",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024034",
            "telephone_number": "812-232-7337",
            "fax_number": "812-232-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "PABLITO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01059798",
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "IN",
            "license": "01059798A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200507050",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.