Active NPI
Jeremy Cruz
- Physician Assistant
- Colton, CA
National Provider Identifier
1114805207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA67310
- Practice address
- 400 N Pepper Ave
Colton, CA 92324-1801 - Phone
- (909) 580-1381
- NPI assigned
- Aug 26, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA67310 | CA | Primary |
Addresses
Primary practice location
400 N Pepper Ave
Colton, CA 92324-1801
Mailing address
5956 Sycamore Canyon Blvd Apt 3043
Riverside, CA 92507-0861
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-6150
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA67310 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America-California | Current | Accepting new patients |
Locations
400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1400
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771977600000",
"number": "1114805207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5956 SYCAMORE CANYON BLVD APT 3043",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925070861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N PEPPER AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "923241801",
"telephone_number": "909-580-1381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "JEREMY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-26",
"last_updated": "2026-02-25",
"certification_date": "2026-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA67310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.