John William Cruz, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

86496 Issued in GA

Practice address

1120 15TH St
Augusta, GA 30912-1000

Phone

(706) 721-8623

Fax

(706) 721-1459

NPI assigned

Mar 3, 2015

Last updated

Oct 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, TN2 enrollments

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 2

Specialty

Emergency Medicine

Education

Rocky Vista University College of Osteopathic Med, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Metro Nashville General Hospital Hospital, Nashville, TN, CCN 440111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  TN

  Medicare reassignment Care Compare group NPD
• Au Medical Associates Emergency Medicine Billing Services, LLC

  • Emergency Medicine Physician
  • Augusta, GA
  • NPI 1982089777
  Medicare reassignment NPD
• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236
  Medicare reassignment NPD
• Metropolitan Hospital Authority

  • Multi-Specialty Clinic/Center
  • Nashville, TN
  • NPI 1710206156
  Medicare reassignment NPD

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

• Nashville General Hospital

  dba Metropolitan Nashville General Hospital

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1568551455
  Care Compare affiliation

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1881086668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST STE BI1056",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309121000",
            "telephone_number": "706-721-8623",
            "fax_number": "706-721-1459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9040 Fitzsimmons Dr",
            "address_purpose": "LOCATION",
            "city": "Joint Base Lewis McChord",
            "state": "WA",
            "postal_code": "984311000",
            "country_code": "US",
            "telephone_number": "253-968-2997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-03",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GU",
            "license": "DO-0086",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "86496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• CS Health & Wellness of North Carolina, LLC
• CS Health & Wellness of Virginia, LLC
• CSB Community Mental Health Center of East Central Georgia (Serenity Behavioral Health Systems)
• CSB of East Cental Ga
• CSB of East Centeal Georgia (Serenity Behavioral Health)

• Emergency Medicine Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.