Individual provider Active NPI

Sylvia S Cruz, DO

  • Obstetrics & Gynecology Physician
  • Martinsburg, WV
National Provider Identifier
1225008105
Registry record updated Apr 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
1634 Issued in WV
Practice address
215 South Louisiana Avenue
Martinsburg, WV 25401
Phone
(304) 267-5559
Fax
(304) 267-5557
NPI assigned
Jan 24, 2006
Last updated
Apr 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 1634 WV Primary
Obstetrics & Gynecology Physician 207V00000X 5101012085 MI
Obstetrics & Gynecology Physician 207V00000X 0102050038 VA

Addresses

Primary practice location

215 South Louisiana Avenue
Martinsburg, WV 25401

Mailing address

215 South Louisiana Avenue
Martinsburg, WV 25401
Phone (304) 267-5559

Other identifiers 3

IdentifierTypeStateIssuer
6213251OtherVAMEDICAID
51D0952997OtherCLIA
0093819000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241009004309 GU Practitioner - Obstetrics/Gynecology 9638219066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

125 Tun Jesus Crisostomo St
Suite 104
Tamuning, GU 96913

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101012085MIMDObstetrics & Gynecology Physician
0102050038VAMDObstetrics & Gynecology Physician
1634WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Todu Guam Foundation LTD CurrentSince Aug 3, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

125 Tun Jesus Crisostomo St
Ste 104
Tamuning, GU 96913
Phone (671) 649-8638

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1225008105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SOUTH LOUISIANA AVENUE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25401",
            "telephone_number": "304-267-5559",
            "fax_number": "304-267-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SOUTH LOUISIANA AVENUE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25401",
            "telephone_number": "304-267-5559",
            "fax_number": "304-267-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "SYLVIA",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WV",
            "license": "1634",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101012085",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0102050038",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "6213251",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "51D0952997",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0093819000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.