Active NPI
Sofia A. De la Cruz, M.D.
- Pediatric Adolescent Medicine Physician
- New York, NY
National Provider Identifier
1245398833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 154771
- Practice address
- 560 W 175TH St
New York, NY 10033-8031 - Phone
- (212) 927-8873
- Fax
- (212) 927-8914
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 154771 | NY | Primary |
Addresses
Primary practice location
560 W 175TH St
New York, NY 10033-8031
Mailing address
560 W 175TH St
New York, NY 10033-8031
Phone (212) 927-8873
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00860944 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- sdelacruz674615@nychhc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245398833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 W 175TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100338031",
"telephone_number": "212-927-8873",
"fax_number": "212-927-8914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 W 175TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100338031",
"telephone_number": "212-927-8873",
"fax_number": "212-927-8914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA CRUZ",
"first_name": "SOFIA",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "NY",
"license": "154771",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00860944",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.