Individual provider Active NPI

Iriselis Cruzado, PA

  • Physician Assistant
  • Sarasota, FL
National Provider Identifier
1063136257
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9116565 Issued in FL
Practice address
2650 Bahia Vista St Ste 204
Sarasota, FL 34239-2625
Phone
(941) 202-1999
Fax
(941) 202-2009
NPI assigned
Sep 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9116565 FL Primary

Addresses

Primary practice location

2650 Bahia Vista St Ste 204
Sarasota, FL 34239-2625

Mailing address

11305 Maybrook Ave
Riverview, FL 33569-5951
Phone (407) 754-6325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221027002388 FL Practitioner - Physician Assistant 0244607679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eric Weinstock MD PAGroup PAC ID 0143309922, 8 clinicians
Tidewater Total Mind Care LLCGroup PAC ID 0648638734, 8 clinicians

Practice addresses (Care Compare)

1300 N W Shore Blvd
240 The Florida Psychiatric Center
Tampa, FL 33607-4629
Phone (813) 636-8300

2650 Bahia Vista St
Suite 204
Sarasota, FL 34239-2625
Phone (941) 202-1999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9116565FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Total Mind Care, LLC CurrentSince May 22, 2026 Accepting new patients

Locations

2650 Bahia Vista St
Ste 204
Sarasota, FL 34239
Phone (941) 202-1999

Interoperability endpoints

  • Direct secure messaging: thefloridapsychiatriccenter.iriseliscruzado@160033.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1063136257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11305 MAYBROOK AVE",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695951",
            "telephone_number": "407-754-6325",
            "fax_number": "941-202-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 BAHIA VISTA ST STE 204",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392625",
            "telephone_number": "941-202-1999",
            "fax_number": "941-202-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZADO",
        "first_name": "IRISELIS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-30",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.