Individual provider Active NPI

David Eduardo Newlan De la Cruz

  • Emergency Medicine Physician
  • Saint Joseph, MO
National Provider Identifier
1518463124
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2022031948 Issued in MO
Practice address
5325 Faraon St
Saint Joseph, MO 64506-3488
Phone
(816) 271-6122
Fax
(816) 271-6019
NPI assigned
Apr 3, 2018
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 73014-20 WI
Emergency Medicine Physician 207P00000X 2022031948 MO Primary

Addresses

Primary practice location

5325 Faraon St
Saint Joseph, MO 64506-3488

Mailing address

5301 Faraon St Ste 120
Saint Joseph, MO 64506-3512
Phone (816) 271-6122

Other practice location 1

Uw Hospital and Clinics 600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

Other practice location 2

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 731-4101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210825003924 WI Practitioner - Emergency Medicine 9830446038 Reassigns benefits to 1 organization
I20220923000964 MO Practitioner - Emergency Medicine 9830446038 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

705 N College St
Albany, MO 64402-1433
Phone (660) 726-3941

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Center Association Inc CurrentSince Sep 29, 2022 Accepting new patients
Mosaic Medical Center - Maryville Emergency Medicine CurrentSince Sep 20, 2022 Accepting new patients
Northwest Medical Center Association Inc Emergency Medicine CurrentSince Sep 29, 2022 Accepting new patients
Mosaic Medical Center - Maryville CurrentSince Sep 20, 2022 Accepting new patients
Heartland Regional Medical Center Emergency Medicine Current Accepting new patients
Heartland Regional Medical Center CurrentSince Aug 22, 2022 Accepting new patients
Heartland Regional Medical Center CurrentSince Aug 22, 2022 Accepting new patients

Locations

705 N College St
Albany, MO 64402
Phone (660) 726-3941

2016 S Main St
Maryville, MO 64468
Phone (660) 562-2525

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

5301 Faraon St
Ste 120
Saint Joseph, MO 64506
Phone (816) 271-6406

5325 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-3500

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1395

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1518463124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 FARAON ST STE 120",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063512",
            "telephone_number": "816-271-6122",
            "fax_number": "816-271-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6122",
            "fax_number": "816-271-6019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Uw Hospital and Clinics 600 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-263-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1818 N Meade St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549113454",
            "country_code": "US",
            "telephone_number": "920-731-4101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "DAVID",
        "middle_name": "EDUARDO NEWLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "73014-20",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2022031948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.