Individual provider Active NPI

Anthony Ralebh Cruz, PA-C

  • Physician Assistant
  • El Dorado, KS
National Provider Identifier
1356214779
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
620 W Central Ave
El Dorado, KS 67042-2111
Phone
(316) 321-3300
NPI assigned
Sep 24, 2025
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

620 W Central Ave
El Dorado, KS 67042-2111

Mailing address

5352 N Nolen St
Bel Aire, KS 67220
Phone (620) 660-2004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20251216004329 KS Practitioner - Physician Assistant 7113412230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susan B Allen Memorial HospitalGroup PAC ID 7719898980, 26 clinicians

Practice addresses (Care Compare)

620 W Central Ave
Sba Urgent Clinic
El Dorado, KS 67042-2111
Phone (316) 452-5860

720 W Central Ave
El Dorado, KS 67042-2112

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Susan B. Allen Memorial Hospital CurrentSince Dec 1, 2025 Accepting new patients
Susan B. Allen Memorial Hospital Current Accepting new patients
Susan B. Allen Memorial Hospital CurrentSince Dec 1, 2025 Accepting new patients

Locations

620 W Central Ave
El Dorado, KS 67042
Phone (316) 321-3300

720 W Central Ave
El Dorado, KS 67042
Phone (316) 321-3000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1356214779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5352 N NOLEN ST",
            "city": "BEL AIRE",
            "state": "KS",
            "postal_code": "67220",
            "telephone_number": "620-660-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W CENTRAL AVE",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670422111",
            "telephone_number": "316-321-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "ANTHONY",
        "middle_name": "RALEBH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, KS

Sources for this page

Verify at the official NPI Registry.