Individual provider Active NPI

Danilo L Cruz, M.D.

  • Internal Medicine Physician
  • San Angelo, TX
National Provider Identifier
1508882952
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q3351 Issued in TX
Practice address
3502 Knickerbocker Rd
San Angelo, TX 76904-7671
Phone
(325) 658-1511
Fax
(325) 481-2166
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E3458 AR
Internal Medicine Physician 207R00000X Q3351 TX Primary

Addresses

Primary practice location

3502 Knickerbocker Rd
San Angelo, TX 76904-7671

Mailing address

PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 658-1511

Other identifiers 3

IdentifierTypeStateIssuer
5M472OtherARAR BCBS
149548001MedicaidAR
8EZ607OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20040301000983 AR Practitioner - Internal Medicine 6507753985 Reassigns benefits to 5 organizations
Practice locations: Waldron, AR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q3351TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Paris CurrentSince Mar 1, 2003 Accepting new patients
Ess Hospitalist LLC CurrentSince Jul 23, 2012 Accepting new patients
Mercy Hospital Paris CurrentSince Mar 1, 2003 Accepting new patients
Arkansas Emergency Staffing Solutions, Inc CurrentSince Jul 23, 2012 Accepting new patients
Mercy Hospital Paris CurrentSince Aug 10, 2009 Accepting new patients
Correct Care, Inc. CurrentSince Aug 10, 2011 Accepting new patients
St. Edward Mercy Medical Center Past Accepting new patients
Shannon Clinic Internal Medicine Past Accepting new patients
Shannon Clinic Past Accepting new patients
Mercy Medical Services, Inc Past Accepting new patients

Locations

451 W Locke St
Ashdown, AR 71822
Phone (870) 265-5351

880 W Main St
Booneville, AR 72927
Phone (479) 675-2800

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

1306 W Collin Raye Dr
De Queen, AR 71832
Phone (870) 584-4111

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

801 W River St
Ozark, AR 72949
Phone (479) 667-4138

500 E Academy St
Paris, AR 72855
Phone (479) 963-6101

1341 W 6th St
Waldron, AR 72958
Phone (479) 637-2136

229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225

Organizations & group practices 10

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1508882952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-658-1511",
            "fax_number": "325-481-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047671",
            "telephone_number": "325-658-1511",
            "fax_number": "325-481-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "DANILO",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E3458",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q3351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "5M472",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149548001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8EZ607",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.