Individual provider Active NPI

Larry Roberto Dela Cruz, CERTIFIED SURGICAL F

  • Surgical Assistant
  • San Antonio, TX
National Provider Identifier
1457775439
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
Practice address
218 Mackey Drive
San Antonio, TX 78213
Phone
(210) 218-2902
Fax
(210) 236-9621
NPI assigned
Feb 11, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X Primary

Addresses

Primary practice location

218 Mackey Drive
San Antonio, TX 78213

Mailing address

218 Mackey Drive
San Antonio, TX 78213
Phone (210) 218-2902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
LDLC- Surgical Assistants, LLC Surgical Assistant Past Accepting new patients

Organizations & group practices 1

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": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1457775439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 MACKEY DRIVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78213",
            "telephone_number": "210-218-2902",
            "fax_number": "210-236-9621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 MACKEY DRIVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78213",
            "telephone_number": "210-218-2902",
            "fax_number": "210-236-9621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "LARRY",
        "middle_name": "ROBERTO",
        "name_prefix": "Mr.",
        "credential": "CERTIFIED SURGICAL F",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-11",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.