Individual provider Active NPI

Guillermo Palacios Cruz, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1205723509
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
16914-33 Issued in WI
Practice address
1635 W National Ave
Milwaukee, WI 53204-1130
Phone
(414) 672-1353
NPI assigned
Jun 19, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 16914-33 WI Primary

Addresses

Primary practice location

1635 W National Ave
Milwaukee, WI 53204-1130

Mailing address

1635 W National Ave
Milwaukee, WI 53204-1130
Phone (414) 672-1353

Other practice location 1

2906 S 20th St
Milwaukee, WI 53215-3732
Phone (414) 672-1353

Other practice location 2

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203
Phone (414) 672-1353

Other practice location 3

309 E North St
Waukesha, WI 53188-3718
Phone (414) 672-1353

Other practice location 4

4570 S 27th St
Milwaukee, WI 53221-2145
Phone (414) 672-1353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20251208002810 WI Practitioner - Nurse Practitioner 5193219103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
16TH Street Community Health Center Inc.Group PAC ID 6709876857, 83 clinicians

Practice addresses (Care Compare)

1635 W National Ave
Milwaukee, WI 53204-1130
Phone (414) 672-1353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16914-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sixteenth Street Community Health Centers, Inc. CurrentSince Oct 6, 2025 Accepting new patients
16TH Street Community Health Center Inc. CurrentSince Oct 6, 2025 Accepting new patients

Locations

4570 S 27th St
Milwaukee, WI 53221
Phone (414) 325-8720

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204

1635 W National Ave
Milwaukee, WI 53204
Phone (262) 408-5094

2906 S 20th St
Milwaukee, WI 53215
Phone (414) 385-8800

309 E North St
Waukesha, WI 53188
Phone (262) 408-2530

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": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1205723509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 W NATIONAL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532041130",
            "telephone_number": "414-672-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 W NATIONAL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532041130",
            "telephone_number": "414-672-1353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2906 S 20th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532153732",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1032 S CESAR E CHAVEZ DR",
            "address_purpose": "LOCATION",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042203",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 E North St",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531883718",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4570 S 27th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532212145",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALACIOS CRUZ",
        "first_name": "GUILLERMO",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "16914-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.