Charles Dela Cruz, MD PHD

Key facts

NPI

1467548396

Entity type

Individual (NPI type 1)

Primary specialty

Internal Medicine Physician 207R00000X

License

044484 (CT)

Practice address

293 Summit Street
New Haven, CT 06513

Phone

(203) 710-4688

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

Yes

Organizations & group practices 2

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.

• Yale University Anesthesiology Physician · New Haven, CT · NPI 1205822236
  Medicare reassignment NPD CT · INTERNAL MEDICINE
• Yale University Durable Medical Equipment & Medical Supplies · Fairfield, CT · NPI 1548066962
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cdelacruz2899@direct.ynhh.org

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 11, 2009.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242000000000",
    "number": "1467548396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 SUMMIT ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065134104",
            "telephone_number": "203-710-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 SUMMIT STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06513",
            "telephone_number": "203-710-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "044484",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "044484",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CT",
            "license": "044484",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

• Efua Degraft Johnson, MD
• Caila Degrandi
• Katelyn M Degrazia, LCSW
• Ariana Deignan-Kosmides
• Lucian V Del Priore, M.D.
• Jeffrey Delacruz
• Katherine M Delancy, R.D.
• Eva Marjorie Delappe
• Brooke Nicole Delehoy
• Pamela Delerme, CNM

All providers in New Haven, CT · Internal Medicine Physician in Connecticut