Reynaldo De la Cruz Jr.
Individual provider Active NPI Family Nurse Practitioner · Forestville, MD
NPI 1104630003 · NPPES record last updated May 19, 2026
Key facts
- NPI
- 1104630003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AC007598 (MD)
- Practice address
- 7420 Marlboro Pike
Forestville, MD 20747-4343 - Phone
- (301) 736-0240
- Fax
- (240) 628-7472
- NPI assigned
- Feb 3, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- SNF Physiatry Services MD LLC
Practice addresses (Care Compare)
400 E Pratt St
FL 8
Baltimore, MD 21202-3180
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250610004300 | MD | Practitioner - Nurse Practitioner | 8921518739 | Reassigns benefits to 2 organizations |
| I20250613002357 | DC | Practitioner - Nurse Practitioner | 8921518739 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1194340 | TX | MD | Family Nurse Practitioner |
| 0024192953 | VA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PA Post Acute Services PC | Current |
Accepting new patients | |
| Redefined Health and Wellness LLC | Current | Accepting new patients | |
| CNP Operating Co LLC | Current |
Accepting new patients | |
| Falls Church Pediatrics | Current |
Accepting new patients | |
| Redefined Health and Wellness LLC | Family | Past | Accepting new patients |
| Baby Doc Inc | Past |
Accepting new patients |
Locations
2525 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 367-9100
9211 Stuart Ln
Clinton, MD 20735
Phone (301) 868-3600
7420 Marlboro Pike
Forestville, MD 20747
Phone (301) 424-9560
105 Time Sq
Salisbury, MD 21801
Phone (410) 749-2474
2601 Bel Pre Rd
Silver Spring, MD 20906
Phone (301) 598-6000
6700 Columbia Pike
Annandale, VA 22003
Phone (703) 256-7000
7263 Arlington Blvd
#F
Falls Church, VA 22042
Phone (703) 775-0777
7263F Arlington Blvd
Falls Church, VA 22042
Phone (703) 775-0777
42010 Village Center Plz
Ste 100
Stone Ridge, VA 20105
Phone (703) 542-7921
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FBAHDD/Endpoint/FBAHDD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AC007598 | MD | Yes |
| Family Nurse Practitioner | 363LF0000X | 0024192953 | VA | |
| Family Nurse Practitioner | 363LF0000X | 1194340 | TX |
Addresses
Primary practice location
7420 Marlboro Pike
Forestville, MD 20747-4343
Mailing address
4508 Harvest Rd
Temple Hills, MD 20748-3612
Phone (202) 945-2893
Other providers in Forestville, MD
- Robert Preston Cohen
- Lauren Hallie Collins
- Lucretia Cunningham
- Claudia Darden
- Michael Datiles
- Rabia Dhanani
- Dimensions Wellness II LLC
- DNR Carenet LLC
- Brittany Dorsey-Rawlings
- Dresher Dialysis LLC
All providers in Forestville, MD · Family Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.