DR. MADELINE CRUZ D.P.M.
NPI 1043390131
Podiatrist - Primary Podiatric Medicine in Garnerville, NY

NPI Status: Active since October 16, 2006

Contact Information

3 HEWITT ST
GARNERVILLE, NY
ZIP 10923
Phone: (845) 786-3830
Fax: (845) 786-3830

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  • Individual
  • Female
  • Years of Experience 32
  • Podiatrist
  • Primary Podiatric Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MADELINE CRUZ

This page provides the complete NPI Profile along with additional information for Madeline Cruz, a provider established in Garnerville, New York with a medical specialization in Podiatrist, focusing in primary podiatric medicine and more than 32 years of experience. The healthcare provider is registered in the NPI registry with number 1043390131 assigned on October 2006. The practitioner's primary taxonomy code is 213EP1101X with license number 005347 (NY). The provider is registered as an individual and her NPI record was last updated 18 years ago.

NPI
1043390131
Provider Name
DR. MADELINE CRUZ D.P.M.
Gender
Female
Entity Type
Individual
Location Address
3 HEWITT ST GARNERVILLE, NY 10923
Location Phone
(845) 786-3830
Location Fax
(845) 786-3830
Mailing Address
3 HEWITT ST GARNERVILLE, NY 10923
Mailing Phone
(845) 786-3830
Mailing Fax
(845) 786-3830
Medical School Name
OTHER
Graduation Year
1994
Is Sole Proprietor?
Yes
Enumeration Date
10-16-2006
Last Update Date
06-26-2008
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A podiatrist like Madeline Cruz provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Podiatrist Primary Podiatric Medicine

Taxonomy Code
213EP1101X
Type
Podiatric Medicine & Surgery Service Providers
License No.
005347
License State
NY

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
U65829MEDICARE UPIN (02)NY 
2017970OTHER (01)NYUNITED HEALTHCARE
01742525MEDICAID (05)NY 
4233980001MEDICARE NSC (07)NY 
P00621MEDICARE ID-TYPE UNSPECIFIED (04)NY 

Medicare Participation & PECOS Enrollment Status

Madeline Cruz is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Madeline Cruz is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2062500242

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20071126000132

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Orthotic Devices

  • DME-Orthotic Devices (DF000N)

    For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe (HCPCS:A5500)

    2 DME suppliers used 17 Medicare Claims 34 Services Paid

  • DME-Orthotic Devices (DF000N)

    For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each (HCPCS:A5512)

    1 DME suppliers used 16 Medicare Claims 96 Services Paid

Reviews for DR. MADELINE CRUZ D.P.M.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1043390131, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
4
Doubled → 8
Pos 4
3
Unchanged
Pos 5
3
Doubled → 6
Pos 6
9
Unchanged
Pos 7
0
Doubled → 0
Pos 8
1
Unchanged
Pos 9
3
Doubled → 6
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 3 → 6 0 → 0 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 8 + 3 + 6 + 9 + 0 + 1 + 6 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1043390131.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043390131, enumerated as an "individual" on October 16, 2006.

The provider is located at 3 HEWITT ST GARNERVILLE, NY 10923 and the phone number is (845) 786-3830.

Podiatrist with taxonomy code 213EP1101X and a focus in Primary Podiatric Medicine.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.