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DR. GILBERTO MELCHOR CRUZ M.D.
NPI 1124011515
Psychiatry & Neurology - Neurology in Hialeah, FL

Active since August 31, 2005PECOS EnrolledAccepts Medicare Assignment
4160 W 16TH AVE STE 506, HIALEAH, FL 33012(305) 819-4432(305) 819-3764 Get Directions Write a Review

NPPES record last updated: November 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Gilberto Melchor Cruz M.d. NPPES

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

DR. GILBERTO MELCHOR CRUZ M.D. (NPI 1124011515) is an individual neurology provider in Hialeah, Florida, licensed in Florida (ME0061514) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1987).

NPPES Registry Identity

NPI1124011515
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameDR. GILBERTO MELCHOR CRUZCredential: M.D.
Location Address4160 W 16TH AVE STE 506Hialeah, FL 33012-5884
Mailing Address4160 W 16th Ave Ste 506Hialeah, FL 33012-5884 · (305) 819-4432 · Fax (305) 819-3764
Phone(305) 819-4432
Fax(305) 819-3764
Sole ProprietorYes
Medical School CMSOtherGraduated 1987
Enumeration DateAugust 31, 2005
Last NPPES UpdateNovember 18, 2024
NPPES CertifiedNovember 18, 2024
✔ NPI 1124011515 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in FL · ME0061514
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
4160 W 16TH AVE STE 506, Hialeah, FL 33012
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Other Identifiers 12

Other000L6FL · Preferred Care Partners
Other110105175FL · Railroad Medicare
Other206582FL · Avmed
Other161304FL · Staywell
OtherP00080FL · Doctor Care
Other2507987FL · Cigna
Other10166888FL · Care Plus
Other1016688FL · Well Care
Other14848Blue Cross Blue Shield
Other026753FL · Neighborhood Health Plan
Other210349FL · Amerigroup
Medicaid370756300FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and more.Insurance ›

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

Dr. Gilberto Melchor Cruz M.d. 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 ID2062549454
PECOS Enrollment IDI20100415000733
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 2

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
316 services154 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
39 services39 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33012 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
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
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 2

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

MAYRA CARMEN COSME APRN
Registered Nurse
4160 W 16TH AVE STE 506
HIALEAH, FL 33012
Miami-Dade County (305) 819-4432
MR. RICARDO CAMPOS MUNOZ ARNP
Family Medicine
4160 W 16TH AVE STE 506
HIALEAH, FL 33012
Miami-Dade County (305) 821-3099

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 Gilberto Cruz's NPI number?

The NPI number for Gilberto Cruz is 1124011515. It was assigned to this individual provider in the NPPES registry on August 31, 2005.

Where is Gilberto Cruz located?

Gilberto Cruz practices at 4160 W 16th Ave Ste 506, Hialeah, FL 33012. The listed phone number is (305) 819-4432.

What is Gilberto Cruz's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Gilberto Cruz enrolled in Medicare?

Yes. Gilberto Cruz is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Gilberto Cruz accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare, Oscar Health Maintenance Organization of Florida and Wellpoint list Gilberto 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.

When was this NPI record last updated?

The NPPES record for Gilberto Cruz was last updated on November 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.