NPIMap

Individual provider Active NPI

Randy A Cruell, M.D.

  • Diagnostic Radiology Physician
  • Durham, NC
National Provider Identifier
1114943693
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
200200882 Issued in NC
Practice address
3643 N Roxboro St
Durham, NC 27704-2702
Phone
(919) 470-5272
Fax
(919) 470-5271
NPI assigned
Jul 15, 2006
Last updated
Nov 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 200200882 NC Primary

Addresses

Primary practice location

3643 N Roxboro St
Durham, NC 27704-2702

Mailing address

1121 Situs CT Ste 170
Raleigh, NC 27606-4279
Phone (919) 834-2767

Other identifiers 1

IdentifierTypeStateIssuer
8913121MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070621000034 NC Practitioner - Diagnostic Radiology 9335248038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, Geffen School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granville Health SystemGroup PAC ID 1052223757, 78 clinicians
Durham Radiology Associates IncGroup PAC ID 7719974807, 18 clinicians

Practice addresses (Care Compare)

1010 College St
Oxford, NC 27565-2507
Phone (919) 690-3237

1010 College St Diagnostic Radiology
Oxford, NC 27565-2507
Phone (919) 690-3000

1301 Fayetteville St
Durham, NC 27707-2325
Phone (919) 956-4000

3643 N Roxboro Rd
Durham, NC 27704-2702
Phone (919) 471-4840

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200200882NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Durham Radiology Associates, Inc. Diagnostic Radiology CurrentSince Aug 1, 2002 Accepting new patients
Granville Health System Diagnostic Radiology CurrentSince Apr 1, 2024 Accepting new patients
Granville Health System Current Accepting new patients

Locations

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

4323 Ben Franklin Blvd
Ste 500
Durham, NC 27704
Phone (919) 471-4840

1010 College St
Oxford, NC 27565
Phone (919) 623-5115

1121 Situs Ct
Ste 170
Raleigh, NC 27606
Phone (919) 834-2767

Interoperability endpoints

  • Direct secure messaging: rcruell177758@direct.medicine.duke.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1114943693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 SITUS CT STE 170",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276064279",
            "telephone_number": "919-834-2767",
            "fax_number": "919-851-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042702",
            "telephone_number": "919-470-5272",
            "fax_number": "919-470-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUELL",
        "first_name": "RANDY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200200882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913121",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.