Individual provider Active NPI

Angel Cristian De la Cruz Tejada, MD

  • Cardiovascular Disease Physician
  • North Venice, FL
National Provider Identifier
1619453412
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME180359 Issued in FL
Practice address
200 Healthcare Way Unit 103
North Venice, FL 34275-3670
Phone
(941) 261-0160
Fax
(941) 261-0165
NPI assigned
Jul 14, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME180359 FL Primary

Addresses

Primary practice location

200 Healthcare Way Unit 103
North Venice, FL 34275-3670

Mailing address

PO Box 947407
Atlanta, GA 30394-7407
Phone (941) 917-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250801001771 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2062957004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ucm Medical Group Sub LLCGroup PAC ID 4688635337, 101 clinicians

Practice addresses (Care Compare)

19550 Governors Hwy
Suite 2000
Flossmoor, IL 60422-2142
Phone (708) 957-8750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.168196ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ucm Medical Group Sub, LLC Cardiovascular Disease CurrentSince Jul 7, 2025 Accepting new patients
SMH Physician Services Inc PastSince Sep 14, 2026 Accepting new patients
SMH Physician Services Inc PastSince Sep 14, 2026 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

27702 Network Pl
Chicago, IL 60673

19550 Governors Hwy
Ste 3800
Flossmoor, IL 60422

19550 Governors Hwy
Ste 2000
Flossmoor, IL 60422
Phone (708) 272-6606

19550 Governors Hwy
Flossmoor, IL 60422
Phone (708) 799-8400

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

Interoperability endpoints

  • Direct secure messaging: adelacruztejadamd310901@uchospital.direct-ci.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 and National Provider Directory roles.

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": "1531526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1619453412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEALTHCARE WAY UNIT 103",
            "city": "NORTH VENICE",
            "state": "FL",
            "postal_code": "342753670",
            "telephone_number": "941-261-0160",
            "fax_number": "941-261-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ TEJADA",
        "first_name": "ANGEL",
        "middle_name": "CRISTIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-14",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME180359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Venice, FL

Sources for this page

Verify at the official NPI Registry.