Individual provider Active NPI

Pablo Cruz Burgos, MD

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1922004134
Registry record updated Oct 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11349 Issued in PR
Practice address
400 Calle Manuel Domenech Ste 304
San Juan, PR 00918-3703
Phone
(787) 282-8181
Fax
(787) 294-9921
NPI assigned
Jun 22, 2005
Last updated
Oct 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11349 PR Primary

Addresses

Primary practice location

400 Calle Manuel Domenech Ste 304
San Juan, PR 00918-3703

Mailing address

113 Paseo del Mar
Luquillo, PR 00773-2902
Phone (919) 946-3340

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
I20040330000881 PR Practitioner - Internal Medicine 9537151881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Ave Domenech
Suite 304
San Juan, PR 00918-3703
Phone (787) 282-8181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11349PRMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cruz Advance Medicine LLC Internal Medicine CurrentSince Oct 18, 2018 Accepting new patients
Cruz Internal Medicine Corp. Internal Medicine Past Accepting new patients
Ges de San Juan, Inc. Past Accepting new patients

Locations

400 Calle Manuel Domenech
Ste 304
San Juan, PR 00918
Phone (787) 282-8181

400 Calle Manuel Domenech
Ste 602A
San Juan, PR 00918
Phone (787) 758-8181

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697846400000",
    "number": "1922004134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 PASEO DEL MAR",
            "city": "LUQUILLO",
            "state": "PR",
            "postal_code": "007732902",
            "telephone_number": "919-946-3340",
            "fax_number": "787-294-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CALLE MANUEL DOMENECH STE 304",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183703",
            "telephone_number": "787-282-8181",
            "fax_number": "787-294-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ BURGOS",
        "first_name": "PABLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2023-10-21",
        "certification_date": "2023-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "11349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.