Individual provider Active NPI

Sonia N Mercado Cruz, MT (ASCP)

  • Clinical Medical Laboratory
  • Juana Diaz, PR
National Provider Identifier
1235314790
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
05-033 Issued in PR
Practice address
PR 1 Km113.5
Juana Diaz, PR 00795
Phone
(787) 318-2111
NPI assigned
Jan 3, 2008
Last updated
Jun 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 05-033 PR Primary

Addresses

Primary practice location

PR 1 Km113.5
Juana Diaz, PR 00795

Mailing address

88 Calle Volga
Villa Serena
Santa Isabel, PR 00757-2550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090216000301 PR Part B Supplier - Independent Clinical Laboratory 1254496870 Practice locations: Juana Diaz, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
05-033PRMDClinical Medical Laboratory
1178PRMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jadel, Corporation CurrentSince Jan 31, 2021 Accepting new patients

Organizations & group practices 1

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": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1235314790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 CALLE VOLGA",
            "address_2": "VILLA SERENA",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "007572550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PR 1 KM113.5",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "00795",
            "telephone_number": "787-318-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO CRUZ",
        "first_name": "SONIA",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "MT (ASCP)",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "05-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juana Diaz, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.