Individual provider Active NPI

Shayranisse Pagan Cruz, MD

  • Psychiatry Physician
  • Miami, FL
National Provider Identifier
1386182632
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
31438 Issued in FL
Practice address
9066 SW 73Rd CT
Miami, FL 33156-2964
Phone
(787) 384-8442
NPI assigned
Feb 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 31438 FL Primary
General Practice Physician 208D00000X 19699 PR

Addresses

Primary practice location

9066 SW 73Rd CT
Miami, FL 33156-2964

Mailing address

9066 SW 73Rd CT Apt 1202
Miami, FL 33156-2968
Phone (787) 384-8442

Other practice location 1

Hospital Auxilio Mutuo Avenida Ponce de Leon
Parada 37 1/2
Hato Rey, PR 00919
Phone (787) 758-2000 ext. 3216

Other identifiers 1

IdentifierTypeStateIssuer
19699MedicaidPR

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240603003521 FL Practitioner - Psychiatry 4082960711 Practice locations: Miami, FL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31438FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1386182632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9066 SW 73RD CT APT 1202",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562968",
            "telephone_number": "787-384-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9066 SW 73RD CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562964",
            "telephone_number": "787-384-8442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Hospital Auxilio Mutuo Avenida Ponce de Leon",
            "address_2": "Parada 37 1/2",
            "address_purpose": "LOCATION",
            "city": "Hato Rey",
            "state": "PR",
            "postal_code": "00919",
            "country_code": "US",
            "telephone_number": "787-758-2000 x3216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGAN CRUZ",
        "first_name": "SHAYRANISSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "31438",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19699",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19699",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.