Individual provider Active NPI

Luis M. Cruz Cruz, M.D.

  • Ophthalmology Physician
  • Mayaguez, PR
National Provider Identifier
1093773731
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
7686 Issued in PR
Practice address
55 Calle Dr Basora N
Oficina 109
Mayaguez, PR 00680-4810
Phone
(787) 834-6290
Fax
(787) 831-4206
NPI assigned
May 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 7686 PR Primary

Addresses

Primary practice location

55 Calle Dr Basora N
Oficina 109
Mayaguez, PR 00680-4810

Mailing address

55 Norte, Calle Dr. Basora , Edificio Medico IV
Oficina 109
Mayaguez, PR 00680
Phone (787) 834-6290

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110706000401 PR Practitioner - Ophthalmology 1153509575 Practice locations: Mayaguez, PR; San Sebastian, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7686PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093773731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NORTE, CALLE DR. BASORA , EDIFICIO MEDICO IV",
            "address_2": "OFICINA 109",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-834-6290",
            "fax_number": "787-831-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CALLE DR BASORA N",
            "address_2": "OFICINA 109",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006804810",
            "telephone_number": "787-834-6290",
            "fax_number": "787-831-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ CRUZ",
        "first_name": "LUIS",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "7686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.