Individual provider Active NPI

Danna Glore Michelle Dela Cruz, MD

  • Internal Medicine Physician
  • Forked River, NJ
National Provider Identifier
1689602369
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07164600 Issued in NJ
Practice address
731 Lacey Road
Suite 1
Forked River, NJ 08731
Phone
(609) 242-0040
Fax
(609) 242-8119
NPI assigned
Jun 29, 2006
Last updated
Dec 31, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA07164600 NJ Primary

Addresses

Primary practice location

731 Lacey Road
Suite 1
Forked River, NJ 08731

Mailing address

731 Lacey Road
Suite 1
Forked River, NJ 08731
Phone (609) 242-0040

Other identifiers 1

IdentifierTypeStateIssuer
0038318MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20040813000139 NJ Practitioner - Internal Medicine 4486627056 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rwjbh Primary Care ServicesGroup PAC ID 0749699346, 266 clinicians

Practice addresses (Care Compare)

731 Lacey Rd
Suite 1
Forked River, NJ 08731-1364
Phone (609) 242-0040

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Primary Care Services Internal Medicine CurrentSince Oct 2, 2021 Accepting new patients
Barnabas Health Medical Group, PC Internal Medicine CurrentSince Aug 1, 2015 Accepting new patients
Community Medical Center Inc Past Accepting new patients

Locations

731 Lacey Rd
Ste 1
Forked River, NJ 08731
Phone (609) 242-0040

166 Lyons Ave
Newark, NJ 07112
Phone (973) 926-7300

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

766 Shrewsbury Ave
Ste 100
Tinton Falls, NJ 07724
Phone (732) 945-2009

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838

65 Lacey Rd
Ste A
Whiting, NJ 08759
Phone (732) 350-0404

Interoperability endpoints

  • Direct secure messaging: ddelacruz@direct.rwjbh.org
  • Direct secure messaging: ddelacruz45862@epicdirect.rwjbh.org

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, 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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1689602369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 LACEY ROAD",
            "address_2": "SUITE 1",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "08731",
            "telephone_number": "609-242-0040",
            "fax_number": "609-242-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 LACEY ROAD",
            "address_2": "SUITE 1",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "08731",
            "telephone_number": "609-242-0040",
            "fax_number": "609-242-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "DANNA",
        "middle_name": "GLORE MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07164600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0038318",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forked River, NJ

Sources for this page

Verify at the official NPI Registry.