Ivan Ariel Cruz Repollet, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME153523 Issued in FL

Practice address

4340 W Hillsborough Ave Ste 210
Tampa, FL 33614-5522

Phone

(813) 425-8970

Fax

(813) 425-8925

NPI assigned

Jul 9, 2014

Last updated

Jan 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PR, FL2 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

Specialty

General Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guidewell Sanitas I, LLCGroup PAC ID 9537447107, 124 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ivan.cruzrepollet@conviva.eclinicaldirectplus.com
• Direct secure messaging: ivan.cruzrepollet@wwmp.eclinicaldirectplus.com

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.

• Guidewell Sanitas I, LLC

  dba Clinisanitas

  • Family Medicine Physician
  • Doral, FL
  • NPI 1396124046

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Best Value Healthcare LLC

  dba MaxHealth

  • Internal Medicine Physician
  • Clearwater, FL
  • NPI 1790152015

  Single Specialty

  Medicare reassignment NPD
• Conviva Medical Center Management LLC

  dba Conviva Care Center

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1649324278

  Single Specialty

  Medicare reassignment NPD
• Stanton County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Johnson, KS
  • NPI 1700980026
  NPD

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1609282722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 W HILLSBOROUGH AVE STE 210",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336145522",
            "telephone_number": "813-425-8970",
            "fax_number": "813-425-8925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 W HILLSBOROUGH AVE STE 210",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336145522",
            "telephone_number": "813-425-8970",
            "fax_number": "813-425-8925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ REPOLLET",
        "first_name": "IVAN",
        "middle_name": "ARIEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-09",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "13,569-I",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME153523",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0441252",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME153523",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19,231",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ivan.cruzrepollet@conviva.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4340 W Hillsborough Ave Ste 210",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336145522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lazaro Eduardo Cruz Mesa
• Karla Cruz Montoya
• Ismaray Cruz Moreno
• Christian Xavier Cruz Pico, M.D.
• Dailyn Cruz Reinoso
• Leonardo Cruz Rivadeneira
• Myrta Cruz Rivera
• Luis Cruz Rodriguez Sr.
• Susana Cruz Rumbaut
• Yusleidy Cruz Santana

• General Practice Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.