Individual provider Active NPI

Cruz Martin Cardenas Jr.

  • Physician Assistant
  • Edinburg, TX
National Provider Identifier
1659004109
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17067 Issued in TX
Practice address
2821 Michaelangelo Dr Ste 204
Edinburg, TX 78539-1423
Phone
(956) 362-8290
Fax
(956) 362-8295
NPI assigned
Jul 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17067 TX Primary

Addresses

Primary practice location

2821 Michaelangelo Dr Ste 204
Edinburg, TX 78539-1423

Mailing address

PO Box 749
Pharr, TX 78577-1614
Phone (956) 362-8290

Other practice location 1

2821 Michaelangelo Dr Ste 200
Edinburg, TX 78539-1406
Phone (956) 362-8289

Other practice location 2

1201 W University Dr
Edinburg, TX 78539-2909
Phone (956) 665-7049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231012002049 TX Practitioner - Physician Assistant 0941655831 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renaissance Medical FoundationGroup PAC ID 1153409867, 178 clinicians

Practice addresses (Care Compare)

2821 W Michaelangelo Dr
Edinburg, TX 78539-1405

5501 S McColl Rd
Edinburg, TX 78539-5503
Phone (956) 362-2171

Hospital & facility affiliations

  • Doctors Hosptal at Renaissance Hospital, Edinburg, TX, CCN 450869

Merit-based Incentive Payment System (MIPS)

Final score
98.1 of 100Reported as group
Quality
86
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Hospital at Renaissance, LTD PastSince Oct 15, 2023 Accepting new patients

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": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1659004109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785771614",
            "telephone_number": "956-362-8290",
            "fax_number": "956-362-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 MICHAELANGELO DR STE 204",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785391423",
            "telephone_number": "956-362-8290",
            "fax_number": "956-362-8295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2821 Michaelangelo Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785391406",
            "country_code": "US",
            "telephone_number": "956-362-8289",
            "fax_number": "956-362-8295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 W University Dr",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785392909",
            "country_code": "US",
            "telephone_number": "956-665-7049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "CRUZ",
        "middle_name": "MARTIN",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-01",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.