MR. REYNALDO DE LA CRUZ JR.
NPI 1104630003
Nurse Practitioner - Family in Forestville, MD

Q: What is Reynaldo De La Cruz's NPI number?

The NPI number for Reynaldo De La Cruz is 1104630003. It was assigned to this individual provider in the NPPES registry on February 3, 2025.

Q: What is Reynaldo De La Cruz's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since February 03, 2025PECOS EnrolledAccepts Medicare Assignment

7420 MARLBORO PIKE, FORESTVILLE, MD 20747(301) 736-0240(240) 628-7472 Get Directions Write a Review

NPPES record last updated: May 19, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 19, 2026, Feb 3, 2025 (2 updates tracked since 2025).

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About Mr. Reynaldo De La Cruz Jr. NPPES

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

MR. REYNALDO DE LA CRUZ JR. (NPI 1104630003) is an individual family provider in Forestville, Maryland, licensed in Maryland (AC007598) and active in the NPI registry since February 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1104630003

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameMR. REYNALDO DE LA CRUZ JR.

Location Address7420 MARLBORO PIKEForestville, MD 20747-4343

Mailing Address4508 Harvest RdTemple Hills, MD 20748-3612 · (202) 945-2893 · Fax (240) 628-7472

Phone(301) 736-0240

Fax(240) 628-7472

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateFebruary 3, 2025

Last NPPES UpdateMay 19, 20262 updates tracked since enumeration

NPPES CertifiedMay 19, 2026

✔ NPI 1104630003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in MD · AC007598✔ Licensed in VA · 0024192953✔ Licensed in TX · 1194340

7420 MARLBORO PIKE, Forestville, MD 20747

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Reynaldo De La Cruz Jr. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921518739

PECOS Enrollment IDI20250613002357

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20747 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

$100.31 typical visit price

range $65.18 – $194.86

Typical copayment $25.07 (range $16.29 – $48.71)

Most-billed visit code 99203

Established Patient

$113.72 typical visit price

range $21.40 – $158.88

Typical copayment $28.43 (range $5.35 – $39.72)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

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

MILLENNIUM HEALTH AND REHABILITATION CENTER OF FORESTVILLE LLC

Skilled Nursing Facility