Kariktan Cruz, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD125758 Issued in OR

Practice address

1900 Woodland Dr
Coos Bay, OR 97420-2045

Phone

(541) 267-5151

Fax

(541) 266-4501

NPI assigned

Sep 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Pediatric Medicine

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Bend Medical Center IncGroup PAC ID 5597677716, 92 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcruz124387@secure.stcharleshealthcare.org

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• North Bend Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Coos Bay, OR
  • NPI 1407812365

  Corporate Director

  CMS ownership

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.

• North Bend Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Coos Bay, OR
  • NPI 1407812365
  Medicare reassignment Care Compare group NPD
• NBMC Day Surgery Inc

  • Ambulatory Surgical Clinic/Center
  • Coos Bay, OR
  • NPI 1811437882
  NPD
• North Bend Medical Center Inc

  • Diagnostic Radiology Physician
  • Coos Bay, OR
  • NPI 1063428308
  NPD (past)

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1275720054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202045",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202045",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "KARIKTAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD125758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "161133",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TAX ID FOR BILLING",
            "identifier": "93-0635514",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1407812365",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "R0000WFBTV",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles E Couture, CRNA
• Creative Roots Therapy LLC
• Kathryn Creer, PT
• Troy Alan Cribbins, PT
• Kelly Ray Crowder Jr.
• Alexander Csajko, OT
• Julie Ann Cummings, RD LD
• Aleksandar Curcin, MD
• Johanna Curelo, LPC, ATR-BC
• Erin Danielson

• Pediatrics Physician in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.