Dmitri De la Cruz, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G54368 Issued in CA

Practice address

311 W I St
Los Banos, CA 93635-3479

Phone

(209) 826-2222

Fax

(209) 826-2599

NPI assigned

Jul 31, 2006

Last updated

Jun 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: dmitri.de.la.cruz.1@3550.direct.athenahealth.com

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.

• Karthikeya Devireddy MD Inc

  dba apex medical group inc

  • Rural Health Clinic/Center
  • Los Banos, CA
  • NPI 1518089507

  Pediatrics

  NPD (past)
• KD Medical Group Inc

  dba Padres Medical Imaging,Inc.

  • Family Medicine Physician
  • Los Banos, CA
  • NPI 1457522567

  Pediatrics

  NPD (past)
• Sutter Gould Medical Foundation

  dba Dale Road Care Center

  • Family Medicine Physician
  • Modesto, CA
  • NPI 1326093360
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1154337053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353479",
            "telephone_number": "209-826-2222",
            "fax_number": "209-826-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353479",
            "telephone_number": "209-826-2222",
            "fax_number": "209-826-2599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 W I St # B",
            "address_purpose": "LOCATION",
            "city": "Los Banos",
            "state": "CA",
            "postal_code": "936353479",
            "country_code": "US",
            "telephone_number": "209-826-2222",
            "fax_number": "209-826-2599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W I St",
            "address_purpose": "LOCATION",
            "city": "Los Banos",
            "state": "CA",
            "postal_code": "936353459",
            "country_code": "US",
            "telephone_number": "209-827-9999",
            "fax_number": "209-827-9998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1549 Golden Gate Ave",
            "address_purpose": "LOCATION",
            "city": "Dos Palos",
            "state": "CA",
            "postal_code": "936202329",
            "country_code": "US",
            "telephone_number": "209-392-0022",
            "fax_number": "209-392-0011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "DMITRI",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G54368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "G54368",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dasaratha R Vemireddy MD Inc
• Rachel Davies
• Davis Counseling and Therapeutic Services
• Kayla Davis
• Bianca De la Cruz
• Emily Delgadillo
• Valery O Delgado
• Dennis M. Cabangca (Pegasus Medical & Aesthetic Clinic)
• Dental Hygiene Limited
• Karthikeya Devireddy, MD

• Pediatrics Physician in Los Banos, CA
• Providers in Los Banos, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.