ANTONIO P. CRUZ MD
NPI 1063603553
Dermatology - MOHS-Micrographic Surgery in Providence, RI

Active since August 08, 2007PECOS Enrolled
75/100
CMS Quality Rating
1287 N MAIN ST, PROVIDENCE, RI 02904(401) 272-2724(401) 272-2784 Get Directions Write a Review

NPPES record last updated: October 14, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 14, 2020, Sep 30, 2020, Dec 13, 2019 and 1 more (4 updates tracked since 2019).

About Antonio P. Cruz Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANTONIO P. CRUZ MD (NPI 1063603553) is an individual mohs-micrographic surgery provider in Providence, Rhode Island, licensed in Rhode Island (MD13344) and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS, is affiliated with The Miriam Hospital, and maintains a secondary practice location in Swansea.

NPPES Registry Identity

NPI1063603553
Entity TypeIndividualMale
Primary Taxonomy207ND0101X
Provider Legal NameANTONIO P. CRUZCredential: MD
Location Address1287 N MAIN STProvidence, RI 02904-1856
Mailing Address1287 N Main StProvidence, RI 02904-1856 · (401) 272-2724 · Fax (401) 272-2784
Fax(401) 272-2784
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateAugust 8, 2007
Last NPPES UpdateOctober 14, 20204 updates tracked since enumeration
NPPES CertifiedOctober 14, 2020
NPI 1063603553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Licenses Licensed in RI · MD13344 Licensed in MA · 246717
Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Also ListedDermatologyTaxonomy 207N00000X · License 246717 (MA), MD13344 (RI)
1287 N MAIN ST, Providence, RI 02904

Secondary Practice Location 1

Location 11675 GAR HwySwansea, MA 02777-3901 · Phone (401) 272-2724 · Fax (401) 272-2784

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Antonio P. Cruz Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951595362
PECOS Enrollment IDI20101029000996, I20200206001330
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 20

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks 17311
This procedure involves the careful removal of a growth from the head, neck, hands, or feet. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to study its characteristics and determine the nature of the growth.
305 services254 patients
Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks 17313
This procedure involves the removal of a growth from your trunk, arms, or legs. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to identify any abnormalities. This helps in diagnosing and planning further treatment.
221 services157 patients
Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks 17312
This procedure involves the careful removal of abnormal growths from the head, neck, hands, or feet. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any irregularities. The process may be carried out in multiple stages for thorough examination.
203 services128 patients
Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks 17314
This procedure involves removing growths from the trunk, arms, or legs. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any abnormalities. This aids in diagnosing and treating your condition effectively.
91 services59 patients
Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm 13121
This is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.
89 services74 patients
Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm 13132
This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.
82 services77 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

The Miriam Hospital

Acute Care Hospitals · Providence, RI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number410012
Location164 Summit AvenueProvidence, RI 02906 · Providence County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02904 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$72.93 typical visit price
range $18.92 – $144.38
Typical copayment $18.23 (range $4.73 – $36.09)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%620 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
92%274 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
94%706 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
61%1,212 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
44%972 patients2/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
96%3,497 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
35%2,228 patients2/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 2,971 patients
Patients tobacco: 99% · 2,971 patients
97%123 patients4/55-star benchmark: 98%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
98%2,971 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
16%1,212 patients1/55-star benchmark: 100%
Psoriasis: Clinical Response to Oral Systemic or Biologic Medications
Percentage of psoriasis vulgaris patients receiving oral systemic or biologic therapy who meet minimal physician-or patient- reported disease activity levels.
95%38 patients
Tobacco Use and Help with Quitting Among Adolescents
The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user
100%232 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology
1287 N MAIN ST
PROVIDENCE, RI 02904
Dermatology
1287 N MAIN ST
PROVIDENCE, RI 02904
Physician Assistant
1287 N MAIN ST
PROVIDENCE, RI 02904
Clinic/Center
1287 N MAIN ST
PROVIDENCE, RI 02904
Physician Assistant
1287 N MAIN ST
PROVIDENCE, RI 02904
Physician Assistant
1287 N MAIN ST
PROVIDENCE, RI 02904
Physician Assistant
1287 N MAIN ST
PROVIDENCE, RI 02904

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Antonio Cruz's NPI number?

The NPI number for Antonio Cruz is 1063603553. It was assigned to this individual provider in the NPPES registry on August 8, 2007.

Where is Antonio Cruz located?

Antonio Cruz practices at 1287 N Main St, Providence, RI 02904. The listed phone number is (401) 272-2724.

What is Antonio Cruz's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Antonio Cruz enrolled in Medicare?

Yes. Antonio Cruz is registered in the Medicare PECOS enrollment system.

What insurance does Antonio Cruz accept?

Health plans from Anthem Blue Cross and Blue Shield list Antonio Cruz as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Antonio Cruz affiliated with any hospitals?

According to CMS data, Antonio Cruz is affiliated with The Miriam Hospital.

When was this NPI record last updated?

The NPPES record for Antonio Cruz was last updated on October 14, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.