Individual provider Active NPI

Yadira Rodriguez Cruz, M.D.

  • Family Medicine Physician
  • Lares, PR
National Provider Identifier
1124334198
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17938 Issued in PR
Practice address
Carr. 129 KM. 10.8
Lares, PR 00669-0359
Phone
(787) 612-4887
NPI assigned
Aug 27, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17938 PR Primary

Addresses

Primary practice location

Carr. 129 KM. 10.8
Lares, PR 00669-0359

Mailing address

PO Box 359
Lares, PR 00669-0359
Phone (787) 612-4887

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
I20110817000236 PR Practitioner - Family Practice 7214106814 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17938PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lares Medical Center Inc Current Accepting new patients
Lares Medical Center Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1124334198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 359",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690359",
            "telephone_number": "787-612-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 129 KM. 10.8",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690359",
            "telephone_number": "787-612-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ CRUZ",
        "first_name": "YADIRA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "17938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lares, PR

Sources for this page

Verify at the official NPI Registry.