Individual provider Active NPI

Regino Cruz Olivo, MD

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1659311611
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9855 Issued in PR
Practice address
Carr #3 KM 11.6
Barrio Martin Gonzalez
Carolina, PR 00986-0000
Phone
(787) 477-7711
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 9855 PR Primary

Addresses

Primary practice location

Carr #3 KM 11.6
Barrio Martin Gonzalez
Carolina, PR 00986-0000

Mailing address

Ro 95 Plaza Norte
Urb Riachuelo
Trujillo Alto, PR 00976-0000
Phone (787) 477-7711

Other identifiers 1

IdentifierTypeStateIssuer
38661200MedicaidPR

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1659311611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RO 95 PLAZA NORTE",
            "address_2": "URB RIACHUELO",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009760000",
            "telephone_number": "787-477-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR #3 KM 11.6",
            "address_2": "BARRIO MARTIN GONZALEZ",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009860000",
            "telephone_number": "787-477-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ OLIVO",
        "first_name": "REGINO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38661200",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.