Organization Active NPI

Cruz Advance Medicine LLC

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1770983173
Registry record updated Oct 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
341826 Issued in PR
Legal business name
CRUZ ADVANCE MEDICINE LLC
Practice address
400 Calle Manuel Domenech Ste 304
San Juan, PR 00918-3703
Phone
(787) 282-8181
Fax
(787) 294-9921
NPI assigned
Sep 4, 2014
Last updated
Oct 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2023

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

Authorized official

Name
Dr. Pablo Cruz-Burgos, MDNPI 1922004134
Title
President
Phone
(787) 282-8181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 341826 PR Primary

Addresses

Primary practice location

400 Calle Manuel Domenech Ste 304
San Juan, PR 00918-3703

Mailing address

113 Paseo del Mar
Luquillo, PR 00773-2902
Phone (787) 282-8181

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141106001290 PR Part B Supplier - Clinic/Group Practice 4486876489 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

400 Calle Manuel Domenech
Ste 304
San Juan, PR 00918
Phone (787) 282-8181

400 Calle Manuel Domenech
Ste 602A
San Juan, PR 00918
Phone (787) 758-8181

527 Calle Cuevas Bustamante
Ste 1
San Juan, PR 00918
Phone (787) 282-8181

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697846400000",
    "number": "1770983173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 PASEO DEL MAR",
            "city": "LUQUILLO",
            "state": "PR",
            "postal_code": "007732902",
            "telephone_number": "787-282-8181",
            "fax_number": "787-294-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CALLE MANUEL DOMENECH STE 304",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183703",
            "telephone_number": "787-282-8181",
            "fax_number": "787-294-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRUZ ADVANCE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-04",
        "last_updated": "2023-10-21",
        "certification_date": "2023-10-21",
        "status": "A",
        "authorized_official_last_name": "CRUZ-BURGOS",
        "authorized_official_first_name": "PABLO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-282-8181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "341826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.