Individual provider Active NPI

Sarah Khosrowsalafi Cruz, CPNP

  • Pediatric Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1821500067
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP135588 Issued in TX
Practice address
5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561
Phone
(210) 541-8281
NPI assigned
Oct 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP135588 TX Primary

Addresses

Primary practice location

5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561

Mailing address

5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561
Phone (210) 541-8281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220624001148 TX Order and Referring Only - Nurse Practitioner 0840679619

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1821500067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD STE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293561",
            "telephone_number": "210-541-8281",
            "fax_number": "210-541-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD STE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293561",
            "telephone_number": "210-541-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "SARAH",
        "middle_name": "KHOSROWSALAFI",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-27",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP135588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.