Individual provider Active NPI

Roberto C De la Cruz, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1457381741
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J6401 Issued in TX
Practice address
5323 Harry Hines Boulevard
Dallas, TX 75390-7201
Phone
(214) 648-9741
Fax
(214) 648-9531
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X J6401 TX
Internal Medicine Physician 207R00000X J6401 TX Primary

Addresses

Primary practice location

5323 Harry Hines Boulevard
Dallas, TX 75390-7201

Mailing address

P.O. Box 845347
Dallas, TX 75284-5347
Phone (214) 648-9741

Other identifiers 2

IdentifierTypeStateIssuer
139309205MedicaidTX
85232YOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110419000072 TX Practitioner - Hospice/Palliative CarePractitioner - Internal MedicinePractitioner - Other (Physician) 9830373711 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J6401TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Mar 18, 2015 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Internal Medicine CurrentSince Mar 18, 2015 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

1801 Inwood Rd
Fl Seventh
Dallas, TX 75235

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: rdelacruz42122@direct.phhs.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1457381741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-648-9741",
            "fax_number": "214-648-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BOULEVARD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907201",
            "telephone_number": "214-648-9741",
            "fax_number": "214-648-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "ROBERTO",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "J6401",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J6401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139309205",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "85232Y",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.