Individual provider Active NPI

Jacinta Dela Cruz

  • Physician Assistant
  • Terre Haute, IN
National Provider Identifier
1841937786
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003608A Issued in IN
Practice address
1310 E Davis Dr
Terre Haute, IN 47802-4034
Phone
(812) 232-7337
NPI assigned
May 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003608A IN Primary

Addresses

Primary practice location

1310 E Davis Dr
Terre Haute, IN 47802-4034

Mailing address

1310 E Davis Dr
Terre Haute, IN 47802-4034
Phone (812) 232-7337

Other names 1

  • Ms. Jacinta Vasco-Delacruz Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10003608AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Child and Adolescent Specialty Group, P.C. PastSince May 16, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jacinta.dela-cruz.1@26578.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1841937786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 E DAVIS DR",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024034",
            "telephone_number": "812-232-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 E DAVIS DR",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024034",
            "telephone_number": "812-232-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "JACINTA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003608A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACINTA",
            "last_name": "VASCO-DELACRUZ",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.