Individual provider Active NPI

Mariana Vigiola Cruz, MD

  • Trauma Surgery Physician
  • Lake Forest, IL
National Provider Identifier
1104184944
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
D0101830 Issued in MD
Practice address
800 N Westmoreland Rd Ste 100
Lake Forest, IL 60045-1671
Phone
(847) 535-7208
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X D0101830 MD Primary
Surgery Physician 208600000X 297702-1 NY
Surgery Physician 208600000X 036153330 IL
Surgery Physician 208600000X M-2253 GU
Trauma Surgery Physician 2086S0127X 036153330 IL

Addresses

Primary practice location

800 N Westmoreland Rd Ste 100
Lake Forest, IL 60045-1671

Mailing address

800 N Westmoreland Rd Ste 100
Lake Forest, IL 60045-1671
Phone (847) 535-7208

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.nm.org/doctors/1104184944/mariana-vigiola-cruz-md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU, MD, DC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210622001147 GU Practitioner - General Surgery 4183953672 Reassigns benefits to 1 organization
I20250603000158 MD Practitioner - General Surgery 4183953672 Reassigns benefits to 1 organization
I20250909004864 DC Practitioner - General Surgery 4183953672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

3007 Tilden St NW
Suite 5N
Washington, DC 20008-3030

7501 Surratts Rd
Clinton, MD 20735-3362
Phone (301) 877-7353

7503 Surratts Rd
Clinton, MD 20735-3358
Phone (301) 868-8000

Hospital & facility affiliations

  • Medstar Southern Maryland Hospital Center Hospital, Clinton, MD, CCN 210062

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
297702NYMDLicensed Practical Nurse
M-2253GUMDSurgery Physician
297702-1NYMDSurgery Physician
036153330ILMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Healthcare Development Incorporated CurrentSince Jul 1, 2021 Accepting new patients
St Agnes Healthcare Inc Surgery CurrentSince Mar 24, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2025 Accepting new patients
St Agnes Healthcare Inc CurrentSince Mar 24, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2025 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

3407 Wilkens Ave
Ste 410
Baltimore, MD 21229
Phone (443) 574-8500

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

3585 Washington Blvd
Halethorpe, MD 21227

Organizations & group practices 6

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 1

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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1104184944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD STE 100",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451671",
            "telephone_number": "847-535-7208",
            "fax_number": "224-271-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD STE 100",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451671",
            "telephone_number": "847-535-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGIOLA CRUZ",
        "first_name": "MARIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MD",
            "license": "D0101830",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "297702-1",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036153330",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GU",
            "license": "M-2253",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036153330",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.nm.org/doctors/1104184944/mariana-vigiola-cruz-md",
            "affiliation": "N",
            "address_1": "800 N Westmoreland Rd Ste 100",
            "city": "Lake Forest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600451671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.