Individual provider Active NPI

Roberto Baylon Dela Cruz Jr., MD

  • Family Medicine Physician
  • Richardson, TX
National Provider Identifier
1912101577
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N1303 Issued in TX
Practice address
1410 E Renner Rd Ste 201
Richardson, TX 75082-2227
Phone
(972) 234-3311
NPI assigned
Jun 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N1303 TX Primary

Addresses

Primary practice location

1410 E Renner Rd Ste 201
Richardson, TX 75082-2227

Mailing address

1410 E Renner Rd Ste 201
Richardson, TX 75082-2227
Phone (972) 234-3311

Other practice location 1

1302 Lane St
Ste 100
Irving, TX 75061-2257
Phone (469) 800-1000

Other identifiers 2

IdentifierTypeStateIssuer
C458-205882801MedicaidTX
205882804MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090728000540 TX Practitioner - Family Practice 7416000104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4001 Worth St
Dallas, TX 75246-1608

Hospital & facility affiliations

  • Accentcare Home Health of McKinney Home health agency, McKinney, TX, CCN 679236
  • Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890
  • Medical City Plano Hospital, Plano, TX, CCN 450651
  • Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N1303TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Healthtexas Provider Network CurrentSince Aug 10, 2011 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Aug 10, 2011 Accepting new patients
Healthtexas Provider Network Family Medicine PastSince Jun 2, 2024 Accepting new patients
Village Chiropractic and Wellness P.L.L.C. Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

1302 Lane St
Ste 100
Irving, TX 75061
Phone (469) 800-1000

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: rdelacruz225640@direct.sw.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1912101577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 E RENNER RD STE 201",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750822227",
            "telephone_number": "972-234-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 E RENNER RD STE 201",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750822227",
            "telephone_number": "972-234-3311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1302 Lane St",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750612257",
            "country_code": "US",
            "telephone_number": "469-800-1000",
            "fax_number": "469-800-1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "ROBERTO",
        "middle_name": "BAYLON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N1303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C458-205882801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205882804",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.