Individual provider Active NPI

Edwin A Cruz, MD

  • Neurology Physician
  • Sacramento, CA
National Provider Identifier
1669556965
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A65646 Issued in CA
Practice address
3000 Q St FL 4
Sacramento, CA 95816-7058
Phone
(916) 733-3372
Fax
(916) 733-5743
NPI assigned
Oct 24, 2006
Last updated
Mar 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A65646 CA Primary

Addresses

Primary practice location

3000 Q St FL 4
Sacramento, CA 95816-7058

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956
Phone (916) 861-1486

Other identifiers 2

IdentifierTypeStateIssuer
0151918MedicaidMT
A65646OtherCAMEDICAL STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070502000390 CA Practitioner - Neurology 3274437470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Saint Louis University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1650 Creekside Dr
Folsom, CA 95630-3400
Phone (916) 983-7476

1700 Prairie City Rd
Folsom, CA 95630-9594
Phone (916) 351-4800

1730 Prairie City Rd
Suite 120
Folsom, CA 95630-9594
Phone (916) 351-4800

3000 Q St
Sacramento, CA 95816-7058
Phone (916) 560-0319

3400 Data Dr
Rancho Cordova, CA 95670-7956

4001 J St
Sacramento, CA 95819-3626
Phone (916) 453-4414

6501 Coyle Ave
Carmichael, CA 95608-0306
Phone (916) 537-5190

6511 Coyle Ave
Carmichael, CA 95608-0306
Phone (916) 556-3300

6555 Coyle Ave
Carmichael, CA 95608-0302

7500 Hospital Dr
Sacramento, CA 95823-5403
Phone (916) 423-6176

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A65646CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Apr 2, 2007 Accepting new patients
Dignity Health Medical Foundation CurrentSince Apr 2, 2007 Accepting new patients
Methodist Healthcare System of San Antonio, LTD., L.L.P. Past Accepting new patients
Dignity Community Care Past Accepting new patients
Dignity Health Past Accepting new patients
Regents of the University of California Past Accepting new patients
Advanced Neurology Specialists PLLC Neurology PastSince Apr 30, 2003 Accepting new patients
Dignity Community Care Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

6555 Coyle Ave
Ste 390
Carmichael, CA 95608
Phone (916) 536-2596

8220 Wymark Dr
Ste 200
Elk Grove, CA 95757
Phone (916) 667-0600

3400 Data Dr
Fl 1
Rancho Cordova, CA 95670
Phone (916) 379-2726

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

3000 Q St
Fl 4
Sacramento, CA 95816
Phone (916) 733-3359

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1669556965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956",
            "telephone_number": "916-861-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 Q ST FL 4",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958167058",
            "telephone_number": "916-733-3372",
            "fax_number": "916-733-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "EDWIN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A65646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0151918",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL STATE LICENSE",
            "identifier": "A65646",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.