Individual provider Active NPI

Kerwin Xadiel Cruz de la Rosa, MD

  • Surgery Physician
  • San Francisco, CA
National Provider Identifier
1184171795
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A207506 Issued in CA
Practice address
1600 Divisadero St FL 4
San Francisco, CA 94143-3010
Phone
(415) 353-7687
NPI assigned
Sep 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 24469 PR
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X A207506 CA Primary
Surgery Physician 208600000X 24469 PR

Addresses

Primary practice location

1600 Divisadero St FL 4
San Francisco, CA 94143-3010

Mailing address

513 Parnassus Ave # S321
San Francisco, CA 94143-2205
Phone (415) 476-1239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250730002439 MI Practitioner - General Surgery 2365959624 Reassigns benefits to 1 organization
I20260604002666 CA Practitioner - General Surgery 2365959624 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Puerto Rico School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22101 Moross Rd
Detroit, MI 48236-2148
Phone (586) 753-0011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A207506CAMDSurgery Physician
24469PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Aug 1, 2025 Accepting new patients
Henry Ford Health St. John Hospital Surgery CurrentSince Aug 1, 2025 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

46591 Romeo Plank Rd
Ste 220
Macomb, MI 48044
Phone (586) 226-6170

29000 Little Mack Ave
Ste B
St Clr Shores, MI 48081
Phone (586) 774-8811

Organizations & group practices 6

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 1

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": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1184171795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 PARNASSUS AVE # S321",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432205",
            "telephone_number": "415-476-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DIVISADERO ST FL 4",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941433010",
            "telephone_number": "415-353-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ DE LA ROSA",
        "first_name": "KERWIN",
        "middle_name": "XADIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24469",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A207506",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PR",
            "license": "24469",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.