Individual provider Active NPI

Rogelio Dela Cruz, MD

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Columbus, GA
National Provider Identifier
1386610210
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
054482 Issued in GA
Practice address
710 Center St
Columbus, GA 31901-1527
Phone
(706) 571-1311
NPI assigned
Feb 28, 2006
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 054482 GA Primary
Pediatrics Physician 208000000X 054482 GA
Pediatric Critical Care Medicine Physician 2080P0203X 054482 GA

Addresses

Primary practice location

710 Center St
Columbus, GA 31901-1527

Mailing address

2490 Riverside Dr
Ste B
Macon, GA 31204-1787
Phone (478) 633-7140

Other practice location 1

3675 J Dewey Gray Cir Ste 300
Augusta, GA 30909-1868
Phone (706) 863-9595

Other practice location 2

3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 863-9595

Other practice location 3

777 Hemlock St
msc 83
Macon, GA 31201-2102
Phone (478) 633-7140

Other identifiers 1

IdentifierTypeStateIssuer
754171554BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040701000079 GA Practitioner - Pediatric Medicine 2365429065 Reassigns benefits to 4 organizations
I20240124003238 VA Practitioner - Emergency Medicine 2365429065 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
054482GAMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph M Still Burn Centers, Inc CurrentSince Feb 4, 2021 Accepting new patients
Emergency Group of Columbus, LLC CurrentSince Dec 30, 2017 Accepting new patients
Emergency Coverage, LLC CurrentSince Feb 1, 2024 Accepting new patients
Central Georgia Emergency Group, LLC CurrentSince Sep 18, 2016 Accepting new patients
Acs Primary Care Physicians - Southeast PC CurrentSince Jul 31, 2019 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients
Physicians Group Services PA Pediatrics Past Accepting new patients
Doctors Hospital of Augusta LLC Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

3675 J Dewey Gray Cir
Ste 300
Augusta, GA 30909
Phone (706) 869-0501

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

777 Hemlock St
#83
Macon, GA 31201
Phone (478) 633-7140

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: rogelio.delacruz@pppc.eclinicaldirectplus.com

Organizations & group practices 8

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1386610210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 RIVERSIDE DR",
            "address_2": "STE B",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312041787",
            "telephone_number": "478-633-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 CENTER ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011527",
            "telephone_number": "706-571-1311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3675 J Dewey Gray Cir Ste 300",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309091868",
            "country_code": "US",
            "telephone_number": "706-863-9595",
            "fax_number": "706-447-7137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3651 Wheeler Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096521",
            "country_code": "US",
            "telephone_number": "706-863-9595",
            "fax_number": "706-447-7137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Hemlock St",
            "address_2": "msc 83",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312012102",
            "country_code": "US",
            "telephone_number": "478-633-7140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "ROGELIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "GA",
            "license": "054482",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "054482",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "GA",
            "license": "054482",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "754171554B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.