Individual provider Active NPI

Jorge Heriberto De la Cruz, MD

  • General Practice Physician
  • Manati, PR
National Provider Identifier
1831937937
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
24597 Issued in PR
Practice address
PO Box 30532
Manati, PR 00674-8513
Phone
(787) 621-3322
Fax
(787) 621-3364
NPI assigned
Jul 15, 2024
Last updated
Jul 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 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 24597 PR Primary

Addresses

Primary practice location

PO Box 30532
Manati, PR 00674-8513

Mailing address

HC 5 Box 45309
Vega Baja, PR 00693-9672
Phone (714) 386-0082

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
I20250829004401 PR Practitioner - General Practice 5496256455 Practice locations: Vega Baja, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carr 160 KM 1
Vega Baja, PR 00693-9828
Phone (714) 386-0082

HC 5 Box
Suite 45309
Vega Baja, PR 00693

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24597PRMDGeneral Practice Physician

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1831937937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 5 BOX 45309",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006939672",
            "telephone_number": "714-386-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 30532",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006748513",
            "telephone_number": "787-621-3322",
            "fax_number": "787-621-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "JORGE",
        "middle_name": "HERIBERTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-15",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.