Edgar R Delacruz MD Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

35043776 Issued in OH

Legal business name

EDGAR R DELACRUZ MD INC

Practice address

715 E Shafer Ave
Dover, OH 44622-2053

Phone

(330) 364-7764

Fax

(330) 343-8162

NPI assigned

Aug 16, 2010

Last updated

Nov 17, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edgar Rodriguez Delacruz, MDNPI 1275593907

Title

Doctor

Phone

(330) 364-7764

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edgar Rodriguez Delacruz, M.D.

  • Specialist
  • Dover, OH
  • NPI 1275593907
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1477868305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 E SHAFER AVE",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222053",
            "telephone_number": "330-364-7764",
            "fax_number": "330-343-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E SHAFER AVE",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222053",
            "telephone_number": "330-364-7764",
            "fax_number": "330-343-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGAR R DELACRUZ MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-16",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "DELACRUZ",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "RODRIGUEZ",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "330-364-7764",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35043776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3090533",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dr Nancy a Brown Inc
• Phebe Anna Duerson
• Amber Dunlap-Ott, NP-C
• Ryan L. Dunn, PH.D.
• Eric M Durbin, RPH
• Misty Elder, NP
• Naqeebullah Elham, MD
• Isabel Celestina Elizardo
• Bernadine Ellis
• Jesse Elmore

• Specialist in Dover, OH
• Providers in Dover, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.