Individual provider Active NPI

Dionisio V Cruz, MD

  • Nephrology Physician
  • Brick, NJ
National Provider Identifier
1609833961
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA03414900 Issued in NJ
Practice address
35 Beaverson Blvd
Ste 5C
Brick, NJ 08723-7858
Phone
(732) 451-0063
Fax
(732) 451-0063
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25MA03414900 NJ Primary

Addresses

Primary practice location

35 Beaverson Blvd
Ste 5C
Brick, NJ 08723-7858

Mailing address

2100 State Route 33
Ste 15
Neptune, NJ 07753-6116
Phone (732) 451-0063

Other identifiers 3

IdentifierTypeStateIssuer
0042599OtherNJAETNA
1709607MedicaidNJ
222271316OtherNJBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20110207000061 NJ Practitioner - Nephrology 9638145998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Care CentersGroup PAC ID 6204279441, 23 clinicians

Practice addresses (Care Compare)

27 S Cooks Bridge Rd
Suite 2 11
Jackson, NJ 08527-2463
Phone (732) 460-1200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03414900NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Care Centers Nephrology CurrentSince Feb 1, 2024 Accepting new patients
Shore Nephrology PA. Nephrology CurrentSince Jan 1, 1989 Accepting new patients
Shore Health Group, PC Past Accepting new patients

Locations

35 Beaverson Blvd
Ste 5C
Brick, NJ 08723
Phone (732) 451-0063

1 Bethany Rd
Ste 91
Hazlet, NJ 07730
Phone (732) 847-3662

27 S Cooks Bridge Rd
Ste 2-11
Jackson, NJ 08527
Phone (732) 575-1100

2100 State Route 33
Ste 15
Neptune, NJ 07753
Phone (732) 988-8228

1031 McBride Ave
Ste D209
Woodland Park, NJ 07424
Phone (973) 222-8387

Interoperability endpoints

  • Direct secure messaging: dionisio.cruz@direct.davitaphysiciansolutions.com

Organizations & group practices 3

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 4

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1609833961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 STATE ROUTE 33",
            "address_2": "STE 15",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077536116",
            "telephone_number": "732-451-0063",
            "fax_number": "732-451-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BEAVERSON BLVD",
            "address_2": "STE 5C",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087237858",
            "telephone_number": "732-451-0063",
            "fax_number": "732-451-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "DIONISIO",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA03414900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0042599",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1709607",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "222271316",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.