Individual provider Active NPI

Eileen Danisis Soto Cruz, MD

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1790515500
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
24077 Issued in PR
Practice address
Ave. Main, #12 BLQ. 54
Bayamon, PR 00959
Phone
(787) 251-7614
Fax
(787) 251-7608
NPI assigned
Aug 6, 2024
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 24077 PR Primary

Addresses

Primary practice location

Ave. Main, #12 BLQ. 54
Bayamon, PR 00959

Mailing address

27 Calle Regina Medina Apt B808
Guaynabo, PR 00969-6012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20250716002914 PR Practitioner - General Practice 0648785774 Practice locations: Bayamon, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24077PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promise Medical P.S.C. PastSince Oct 13, 2024 Accepting new patients

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": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1790515500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CALLE REGINA MEDINA APT B808",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009696012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. MAIN, #12 BLQ. 54",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-251-7614",
            "fax_number": "787-251-7608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO CRUZ",
        "first_name": "EILEEN",
        "middle_name": "DANISIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.