Alfonso Cruz Manuel

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95005711 Issued in CA

Practice address

7653 Coldwater Canyon CT
North Hollywood, CA 91605-2048

Phone

(818) 200-7062

NPI assigned

Dec 25, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Running River Home Health Services Home health agency, Cerritos, CA, CCN 559064

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Integrated Allied Medical Group

  • Family Medicine Physician
  • Burbank, CA
  • NPI 1649970740
  Medicare reassignment NPD
• Woundwell Care Medical Group Inc

  • Nurse Practitioner
  • Los Angeles, CA
  • NPI 1285424853
  Medicare reassignment NPD
• A2 Healthcare System

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1457228660
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Inglewood, CA
  • NPI 1821635079
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Running River Home Health Services

  • Home Health Agency
  • Cerritos, CA
  • NPI 1144374653
  Care Compare affiliation

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

{
    "created_epoch": "1482624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1124563358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7653 COLDWATER CANYON CT",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916052048",
            "telephone_number": "818-200-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7653 COLDWATER CANYON CT",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916052048",
            "telephone_number": "818-200-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "ALFONSO",
        "middle_name": "CRUZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-25",
        "last_updated": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95005711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP FURNISHING NUMBER",
            "identifier": "95005711",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 15th St W",
            "city": "Lancaster",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Manning
• Aline Manouguian
• Anahit Ani Manoukian
• Maneli Masoumeh Mansoori, M.D.
• Parham Mansouri
• Armine Manukyan
• Salaheddin Marashli, DDS
• Marathon Home Health, Inc.
• Marathon Hospice Care Inc.
• Marber Group Inc

• Nurse Practitioner in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.

Verify at the official NPI Registry.