Individual provider Active NPI

Gabriel Arturo Noble Cruz, MD

  • Pediatrics Physician
  • King of Prussia, PA
National Provider Identifier
1649701764
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD481707 Issued in PA
Practice address
550 S Goddard Blvd
King of Prussia, PA 19406-2922
Phone
(610) 337-3232
NPI assigned
Mar 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD481707 PA Primary

Addresses

Primary practice location

550 S Goddard Blvd
King of Prussia, PA 19406-2922

Mailing address

633 W Rittenhouse St Apt A519
Philadelphia, PA 19144-4340

Other practice location 1

86 Calle Onix
Urb Pedregales
Rio Grande, PR 00745-4336
Phone (787) 502-3224

Other practice location 2

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-1000

Other practice location 3

Penn State Health Milton S Hershey Medical Center
500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-8006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190822002091 PA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0042548406

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD481707PAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1649701764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 W RITTENHOUSE ST APT A519",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S GODDARD BLVD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062922",
            "telephone_number": "610-337-3232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "86 Calle Onix",
            "address_2": "Urb Pedregales",
            "address_purpose": "LOCATION",
            "city": "Rio Grande",
            "state": "PR",
            "postal_code": "007454336",
            "country_code": "US",
            "telephone_number": "787-502-3224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1919 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167710",
            "country_code": "US",
            "telephone_number": "602-933-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Penn State Health Milton S Hershey Medical Center",
            "address_2": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-8006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOBLE CRUZ",
        "first_name": "GABRIEL",
        "middle_name": "ARTURO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD481707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

Verify at the official NPI Registry.