Active NPI
Salvador Cruz, MD
- Psychiatry Physician
- Pueblo, CO
National Provider Identifier
1043292907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 23403
- Practice address
- 128 S-Union
Suite C
Pueblo, CO 81003 - Phone
- (719) 543-6988
- Fax
- (719) 542-1290
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 23403 | CO | |
| Psychiatry Physician | 2084P0800X | 23403 | CO | Primary |
Addresses
Primary practice location
128 S-Union
Suite C
Pueblo, CO 81003
Mailing address
128 South Union
Pueblo, CO 81003
Phone (719) 543-6988
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 076679 | Medicaid | CO | |
| DB7127 | Other | RR MEDICARE - GROUP | |
| P00123342 | Other | RR MEDICARE - IND |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284076800000",
"number": "1043292907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 SOUTH UNION",
"city": "PUEBLO",
"state": "CO",
"postal_code": "81003",
"telephone_number": "719-543-6988",
"fax_number": "719-542-1290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 S-UNION",
"address_2": "SUITE C",
"city": "PUEBLO",
"state": "CO",
"postal_code": "81003",
"telephone_number": "719-543-6988",
"fax_number": "719-542-1290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "SALVADOR",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2010-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "23403",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CO",
"license": "23403",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "076679",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE - GROUP",
"identifier": "DB7127",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE - IND",
"identifier": "P00123342",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.