Cruz Martina Fana-Souchet, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME96750 Issued in FL

Practice address

125 Patricia Ave Ste B
Ama Medical Group
Dunedin, FL 34698-8100

Phone

(727) 331-8740

Fax

(727) 331-8744

NPI assigned

Dec 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Cruz Martina Fana Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles (3 of 4)

Locations

Networks

• Optimum HealthCare HMO Network

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.

• Ama Medical Group LLC

  • Internal Medicine Physician
  • Dunedin, FL
  • NPI 1174834717

  FL, Internal Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Ama Network Partners LLC

  • Health Maintenance Organization
  • Dunedin, FL
  • NPI 1114807369
  NPD
• Associated Practice Management

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1003579996

  Internal Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Hospice of the Florida Suncoast, Inc.

  • Community Based Hospice Care Agency
  • Palm Harbor, FL
  • NPI 1124028204

  Hospice

  Care Compare affiliation

Specialty

Internal MedicineAlso: Infectious Disease

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ama Medical Group LLC 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suncoast Hospice Hospice, Palm Harbor, FL, CCN 101508

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1811050602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PATRICIA AVE STE B",
            "address_2": "AMA MEDICAL GROUP",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346988100",
            "telephone_number": "727-331-8740",
            "fax_number": "727-331-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATRICIA AVE STE B",
            "address_2": "AMA MEDICAL GROUP",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346988100",
            "telephone_number": "727-331-8740",
            "fax_number": "727-331-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANA-SOUCHET",
        "first_name": "CRUZ",
        "middle_name": "MARTINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME96750",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME96750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000875300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRUZ",
            "last_name": "FANA",
            "middle_name": "MARTINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Dunedin, FL
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.