Individual provider Active NPI

Rhodora Roque Cruz, APRN, FNP-C

  • Family Nurse Practitioner
  • Tamuning, GU
National Provider Identifier
1770051153
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP0194 Issued in GU
Practice address
1244 N Marine Corps Dr
Tamuning, GU 96913-4308
Phone
(671) 647-8262
Fax
(671) 647-5252
NPI assigned
Nov 5, 2018
Last updated
May 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RX0440 GU
Family Nurse Practitioner 363LF0000X NP0194 GU Primary

Addresses

Primary practice location

1244 N Marine Corps Dr
Tamuning, GU 96913-4308

Mailing address

1244 N Marine Corps Dr
Tamuning, GU 96913-4308
Phone (671) 777-0632

Other practice location 1

850 Governor Carlos Camacho Road
Tamuning, GU 96911
Phone (671) 777-0632

Other practice location 2

850 Governor Carlos Camacho Road
Tamuning, GU 96911
Phone (671) 777-0632

Other names 1

  • Ms. Rhodora Roque Cruz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20190523002161 GU Practitioner - Nurse Practitioner 7911240452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Medical Center, LLCGroup PAC ID 1759311699, 17 clinicians

Practice addresses (Care Compare)

1244 N Marine Corps Dr
Tamuning, GU 96913
Phone (671) 647-8262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RX0440GUMDEmergency Registered Nurse
NP0194GUMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Medical Center, LLC CurrentSince Mar 16, 2019 Accepting new patients

Locations

1244 N Marine Corps Dr
Tamuning, GU 96913
Phone (671) 647-8262

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1770051153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 N MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134308",
            "telephone_number": "671-777-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 N MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134308",
            "telephone_number": "671-647-8262",
            "fax_number": "671-647-5252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 Governor Carlos Camacho Road",
            "address_purpose": "LOCATION",
            "city": "Tamuning",
            "state": "GU",
            "postal_code": "96911",
            "country_code": "US",
            "telephone_number": "671-777-0632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 Governor Carlos Camacho Road",
            "address_purpose": "LOCATION",
            "city": "Tamuning",
            "state": "GU",
            "postal_code": "96911",
            "country_code": "US",
            "telephone_number": "671-777-0632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "RHODORA",
        "middle_name": "ROQUE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "GU",
            "license": "RX0440",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GU",
            "license": "NP0194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RHODORA",
            "last_name": "CRUZ",
            "middle_name": "ROQUE",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.