Individual provider Active NPI

Martin Emmanuel Cruz, PT, DPT

  • Physical Therapist
  • Irvine, CA
National Provider Identifier
1447884093
Registry record updated Feb 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT298128 Issued in CA
Practice address
1 Peters Canyon Rd Ste 120
Irvine, CA 92606-1748
Phone
(949) 679-3988
NPI assigned
Feb 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT298128 CA Primary

Addresses

Primary practice location

1 Peters Canyon Rd Ste 120
Irvine, CA 92606-1748

Mailing address

1762 Green Meadow Ave
Tustin, CA 92780-6661
Phone (714) 489-7542

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200529002610 CA Practitioner - Physical Therapist in Private Practice 2961823984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Select Cal Physical Therapy PCGroup PAC ID 4789070699, 162 clinicians

Practice addresses (Care Compare)

10540 Talbert Ave
Suite 250W
Fountain Valley, CA 92708-6045
Phone (714) 964-0727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT298128CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Cal Physical Therapy PC Physical Therapist CurrentSince Apr 1, 2022 Accepting new patients
Select Cal Physical Therapy PC Physical Therapist Current Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Aug 5, 2021 Accepting new patients
Select Cal Physical Therapy PC CurrentSince Apr 1, 2022 Accepting new patients

Locations

1470 Civic Ct
Ste 320
Concord, CA 94520
Phone (925) 326-2211

9281 Office Park Cir
Ste 100
Elk Grove, CA 95758
Phone (916) 892-1330

2420 Martin Rd
Ste 380
Fairfield, CA 94534
Phone (707) 437-9001

10540 Talbert Ave
Ste 250W
Fountain Vly, CA 92708
Phone (714) 964-0727

4870 Barranca Pkwy
Ste 340
Irvine, CA 92604
Phone (949) 653-7878

10459 Mountain View Ave
Ste G
Loma Linda, CA 92354
Phone (909) 478-9508

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

360 Dardanelli Ln
Ste 1F
Los Gatos, CA 95032
Phone (408) 374-8823

929 Pacific St
Monterey, CA 93940
Phone (831) 373-1209

268 Redwood Shores Pkwy
Redwood City, CA 94065
Phone (650) 591-9581

6180 Brockton Ave
Ste 101
Riverside, CA 92506
Phone (951) 781-6653

1331 Medical Center Dr
Ste A
Rohnert Park, CA 94928
Phone (707) 584-3433

1700 California St
Ste 530
San Francisco, CA 94109
Phone (415) 921-1758

707 Lincoln Ctr
Stockton, CA 95207
Phone (209) 470-5101

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1582329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582329600000",
    "number": "1447884093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 GREEN MEADOW AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806661",
            "telephone_number": "714-489-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PETERS CANYON RD STE 120",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061748",
            "telephone_number": "949-679-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "MARTIN",
        "middle_name": "EMMANUEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-22",
        "last_updated": "2020-02-22",
        "certification_date": "2020-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT298128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.