Individual provider Active NPI

Susan De la Cruz, FNP

  • Family Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1760030290
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140348 Issued in TX
Practice address
6600 N Dessert Blvd
El Paso, TX 79912
Phone
(915) 790-5754
NPI assigned
Aug 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X AP140348 TX Primary

Addresses

Primary practice location

6600 N Dessert Blvd
El Paso, TX 79912

Mailing address

249 Earle PL
El Paso, TX 79928-5899
Phone (915) 204-6201

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
I20201117002757 TX Practitioner - Nurse Practitioner 1951712264 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP140348TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso County Hospital District Multi-Specialty CurrentSince Aug 19, 2024 Accepting new patients
El Paso County Hospital District Multi-Specialty CurrentSince Aug 19, 2024 Accepting new patients

Locations

6600 N Desert Blvd
El Paso, TX 79912
Phone (915) 521-2210

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1760030290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 EARLE PL",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799285899",
            "telephone_number": "915-204-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 N DESSERT BLVD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79912",
            "telephone_number": "915-790-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "SUSAN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2024-08-26",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.