Individual provider Active NPI

Eladio Perez Cruz, MD

  • Gastroenterology Physician
  • San Juan, PR
National Provider Identifier
1194701706
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
8686 Issued in PR
Practice address
1449 Calle Americo Salas
Ste 103
San Juan, PR 00909-2104
Phone
(787) 722-1717
Fax
(787) 723-1595
NPI assigned
Dec 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 8686 PR Primary

Addresses

Primary practice location

1449 Calle Americo Salas
Ste 103
San Juan, PR 00909-2104

Mailing address

PO Box 19006
San Juan, PR 00910-1006
Phone (787) 722-1717

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
I20110228000919 PR Practitioner - GastroenterologyPractitioner - Internal Medicine 0941481675 Practice locations: San Juan, PR; Corozal, PR

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Puerto Rico School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1449 Calle Americo Salas
Suite 103
San Juan, PR 00909-2104
Phone (787) 722-1717

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy451
Upper gastrointestinal (GI) endoscopy for acid reflux206

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8686PRMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Gastro-Endoscopico de la Montana Corp Gastroenterology Past Accepting new patients
Nova Gi LLC Gastroenterology 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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298332800000",
    "number": "1194701706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19006",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009101006",
            "telephone_number": "787-722-1717",
            "fax_number": "787-723-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 CALLE AMERICO SALAS",
            "address_2": "STE 103",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092104",
            "telephone_number": "787-722-1717",
            "fax_number": "787-723-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ CRUZ",
        "first_name": "ELADIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2011-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "8686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.