Individual provider Active NPI

Rachel Dela Cruz Canseco-Berbano, MD

  • Internal Medicine Physician
  • Kingston, PA
National Provider Identifier
1174598965
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD 418104 Issued in PA
Practice address
445 Wyoming Avenue
Kingston, PA 18704
Phone
(570) 718-0505
Fax
(570) 718-0522
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD 418104 PA Primary

Addresses

Primary practice location

445 Wyoming Avenue
Kingston, PA 18704

Mailing address

445 Wyoming Avenue
Kingston, PA 18704
Phone (570) 718-0505

Other identifiers 1

IdentifierTypeStateIssuer
1009424140001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20220329001136 NJ Practitioner - Internal Medicine 5294727285 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 418104PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of New Jersey, P.a. CurrentSince Mar 5, 2022 Accepting new patients
American Current Care of New Jersey PA Current Accepting new patients
American Current Care of New Jersey PA CurrentSince Mar 5, 2022 Accepting new patients

Locations

595 Division St
Elizabeth, NJ 07201
Phone (908) 289-5646

817 E Gate Dr
#102
Mount Laurel, NJ 08054
Phone (856) 778-1090

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174598965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 WYOMING AVENUE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "570-718-0505",
            "fax_number": "570-718-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WYOMING AVENUE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "570-718-0505",
            "fax_number": "570-718-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANSECO-BERBANO",
        "first_name": "RACHEL",
        "middle_name": "DELA CRUZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD 418104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009424140001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.