Individual provider Active NPI

Kathleen Cruz, DO

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1861131708
Registry record updated Jul 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS024778 Issued in PA
Practice address
1020 Sansom St
Philadelphia, PA 19107-5002
Phone
(215) 955-6844
NPI assigned
May 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS024778 PA Primary

Addresses

Primary practice location

1020 Sansom St
Philadelphia, PA 19107-5002

Mailing address

273 Greenland Ave
Ewing, NJ 08638-3629
Phone (327) 423-0737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250722000798 PA Practitioner - Emergency Medicine 0648786194 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS024778PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

1020 Sansom St
Philadelphia, PA 19107
Phone (215) 955-6844

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

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": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752364800000",
    "number": "1861131708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 GREENLAND AVE",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086383629",
            "telephone_number": "327-423-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075002",
            "telephone_number": "215-955-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "KATHLEEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2025-07-13",
        "certification_date": "2025-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS024778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.