Individual provider Active NPI

Michael De la Cruz, DPT

  • Physical Therapist
  • Hoboken, NJ
National Provider Identifier
1760103063
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
80 River St Ste 2E
Hoboken, NJ 07030-5619
Phone
(973) 477-6522
NPI assigned
Sep 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

80 River St Ste 2E
Hoboken, NJ 07030-5619

Mailing address

1320 13TH St
North Bergen, NJ 07047-1859
Phone (551) 482-6230

Other practice location 1

271 Grove Ave Ste C
Verona, NJ 07044-1729
Phone (201) 340-4846

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220928003857 NJ Practitioner - Physical Therapist in Private Practice 1850777897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Pursue Physical Therapy and Performance TrainingGroup PAC ID 9830463009, 6 clinicians

Practice addresses (Care Compare)

271 Grove Ave
Suite C
Verona, NJ 07044-1729
Phone (201) 340-4846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pursue Physical Therapy & Performance Training CurrentSince Sep 16, 2022 Accepting new patients

Locations

80 River St
Ste 2E
Hoboken, NJ 07030
Phone (973) 477-3522

271 Grove Ave
Ste C
Verona, NJ 07044
Phone (201) 340-4846

Organizations & group practices 1

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": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1760103063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 13TH ST",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070471859",
            "telephone_number": "551-482-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 RIVER ST STE 2E",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305619",
            "telephone_number": "973-477-6522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "271 Grove Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "NJ",
            "postal_code": "070441729",
            "country_code": "US",
            "telephone_number": "201-340-4846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.