Individual provider Active NPI

Rian Cruz

  • Physician Assistant
  • Brentwood, NY
National Provider Identifier
1962186973
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1869 Brentwood Rd
Brentwood, NY 11717-4625
Phone
(631) 416-5480
NPI assigned
Jun 12, 2023
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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 Primary

Addresses

Primary practice location

1869 Brentwood Rd
Brentwood, NY 11717-4625

Mailing address

1869 Brentwood Rd
Brentwood, NY 11717-4625
Phone (631) 416-5480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250115000885 NY Practitioner - Physician Assistant 6800324013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun River Health Inc.Group PAC ID 6608783568, 246 clinicians

Practice addresses (Care Compare)

1869 Brentwood Rd
Brentwood, NY 11717-4625
Phone (631) 416-5480

3360 Route 343
Amenia, NY 12501-5619
Phone (845) 838-7038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc. CurrentSince Nov 14, 2024 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

6 Henry St
Beacon, NY 12508
Phone (845) 831-0400

1869 Brentwood Rd
Brentwood, NY 11717
Phone (631) 416-5480

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1962186973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1869 BRENTWOOD RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174625",
            "telephone_number": "631-416-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1869 BRENTWOOD RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174625",
            "telephone_number": "631-416-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "RIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-12",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

Verify at the official NPI Registry.