Active NPI
Luis Jose Cruz
- Medical Physician Assistant
- San Lorenzo, PR
National Provider Identifier
1649946583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 953
- Practice address
- Urb Jardines de Cerro Gordo
Calle 5 B 17
San Lorenzo, PR 00754 - Phone
- (787) 457-9646
- NPI assigned
- Aug 20, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 953 | PR | Primary |
Addresses
Primary practice location
Urb Jardines de Cerro Gordo
Calle 5 B 17
San Lorenzo, PR 00754
Mailing address
Urb Jardines de Cerro Gordo
Calle 5 B 17
San Lorenzo, PR 00754
Phone (787) 457-9646
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 953 | PR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1649946583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB JARDINES DE CERRO GORDO",
"address_2": "CALLE 5 B 17",
"city": "SAN LORENZO",
"state": "PR",
"postal_code": "00754",
"telephone_number": "787-457-9646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "URB JARDINES DE CERRO GORDO",
"address_2": "CALLE 5 B 17",
"city": "SAN LORENZO",
"state": "PR",
"postal_code": "00754",
"telephone_number": "787-457-9646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "LUIS",
"middle_name": "JOSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-20",
"last_updated": "2021-08-20",
"certification_date": "2021-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PR",
"license": "953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Lorenzo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.