Individual provider Active NPI

Sammantha Cacioppo-Cruz, PA

  • Physician Assistant
  • Englewood Cliffs, NJ
National Provider Identifier
1992438543
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028465 Issued in NY
Practice address
910 Sylvan Ave Ste 100
Englewood Cliffs, NJ 07632-3308
Phone
(201) 569-2770
NPI assigned
Jul 1, 2022
Last updated
May 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 028465 NY Primary
Physician Assistant 363A00000X 25MP00921400 NJ

Addresses

Primary practice location

910 Sylvan Ave Ste 100
Englewood Cliffs, NJ 07632-3308

Mailing address

55 Meadows St
Pearl River, NY 10965-1911

Other practice location 1

100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 493-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221116002517 NY Practitioner - Physician Assistant 4082082441 Reassigns benefits to 3 organizations
I20250910003443 NJ Practitioner - Physician Assistant 4082082441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Partners of Englewood PCGroup PAC ID 1153572482, 94 clinicians

Practice addresses (Care Compare)

108 S Ridge St
Rye Brook, NY 10573-2813
Phone (914) 219-0187

222 Mamaroneck Ave
White Plains, NY 10605-1303
Phone (914) 401-4282

2393 Central Park Ave
Yonkers, NY 10710-1215
Phone (914) 219-0393

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

350 Engle St
Englewood, NJ 07631-1808

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028465NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Jan 23, 2025 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Jan 23, 2025 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1992438543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MEADOWS ST",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109651911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SYLVAN AVE STE 100",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323308",
            "telephone_number": "201-569-2770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Woods Rd",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "105951530",
            "country_code": "US",
            "telephone_number": "914-493-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CACIOPPO-CRUZ",
        "first_name": "SAMMANTHA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028465",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00921400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood Cliffs, NJ

Sources for this page

Verify at the official NPI Registry.