Individual provider Active NPI

Andre Cruz

  • Certified Registered Nurse Anesthetist
  • Colton, CA
National Provider Identifier
1669865382
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95000322 Issued in CA
Practice address
400 N Pepper Ave
Colton, CA 92324-1801
Phone
(909) 580-1000
NPI assigned
Mar 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 708797 CA
Certified Registered Nurse Anesthetist 367500000X 95000322 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Colton, CA 92324-1801

Mailing address

7201 S Sepulveda Blvd
Los Angeles, CA 90045-1514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150713003288 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163735614 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Inland Empire Anesthesia Medical Group, IncGroup PAC ID 1052310331, 38 clinicians
Raelle Anesthesia IncGroup PAC ID 8123260874, 11 clinicians

Practice addresses (Care Compare)

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-2440

67555 E Palm Canyon Dr
Suite 117And118
Cathedral City, CA 92234-5467
Phone (760) 656-6111

Hospital & facility affiliations

  • Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
708797CAMDCertified Registered Nurse Anesthetist
95000322CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Empire Anesthesia Medical Group, Inc CurrentSince Jun 1, 2015 Accepting new patients
Raelle Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients
Coachella Valley Anesthesia a Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2023 Accepting new patients
Golden Springs Surgical Center CurrentSince Jan 1, 2022 Accepting new patients

Locations

16030 Kamana Rd
Apple Valley, CA 92307
Phone (760) 617-7718

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

67555 E Palm Canyon Dr
Ste 117
Cathedral City, CA 92234

67555 E Palm Canyon Dr
Ste 117118
Cathedral City, CA 92234
Phone (760) 656-6111

400 N Pepper Ave
Fl 2
Colton, CA 92324
Phone (909) 580-2440

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

700 W El Norte Pkwy
Escondido, CA 92026
Phone (760) 738-7830

12828 Harbor Blvd
#120
Garden Grove, CA 92840
Phone (714) 336-0429

6601 White Feather Rd
Joshua Tree, CA 92252
Phone (760) 366-1500

44139 Monterey Ave
Ste B
Palm Desert, CA 92260
Phone (760) 773-4411

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

6185 Magnolia Ave
Riverside, CA 92506
Phone (951) 215-1442

10694 Magnolia Ave
Riverside, CA 92505
Phone (951) 335-5250

1003 E Brier Dr
Ste 170
Sn Bernrdno, CA 92408
Phone (909) 370-2190

Organizations & group practices 4

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 1

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": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1669865382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 S SEPULVEDA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "ANDRE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-05",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "708797",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.