Individual provider Active NPI

Eddiemar Ortiz Cruz, MD

  • Hematology & Oncology Physician
  • San Juan, PR
National Provider Identifier
1578710422
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
18963 Issued in PR
Practice address
998 Ave Munoz Rivera
998 Ave Munoz Rivera
San Juan, PR 00927-4308
Phone
(787) 722-1248
Fax
(787) 721-6098
NPI assigned
Aug 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 18963 PR Primary
Internal Medicine Physician 207R00000X 12000 I PR

Addresses

Primary practice location

998 Ave Munoz Rivera
998 Ave Munoz Rivera
San Juan, PR 00927-4308

Mailing address

998 Ave Munoz Rivera
998 Ave Munoz Rivera
San Juan, PR 00927-4308
Phone (787) 722-1248

Other names 1

  • Eddiemar Ortiz Cruz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20150210001424 PR Practitioner - Hematology/OncologyPractitioner - Internal Medicine 7012232283 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Ponce School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

998 Ave Munoz Rivera
San Juan, PR 00927-4308
Phone (787) 722-1248

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12000 IPRMDInternal Medicine Physician
18963PRMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1578710422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 AVE MUNOZ RIVERA",
            "address_2": "998 AVE MUNOZ RIVERA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009274308",
            "telephone_number": "787-722-1248",
            "fax_number": "787-721-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 AVE MUNOZ RIVERA",
            "address_2": "998 AVE MUNOZ RIVERA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009274308",
            "telephone_number": "787-722-1248",
            "fax_number": "787-721-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ CRUZ",
        "first_name": "EDDIEMAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-22",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PR",
            "license": "18963",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "12000 I",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDDIEMAR",
            "last_name": "ORTIZ CRUZ",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.