GIAN CARLO CRUZ PT
NPI 1558080556
Physical Therapist in San Antonio, TX

NPI Status: Active since August 23, 2022

Contact Information

1901 BABCOCK RD
SAN ANTONIO, TX
ZIP 78229
Phone: (210) 680-5033
Fax: (210) 680-6094

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  • Individual
  • Male
  • Years of Experience 4
  • Physical Therapist
  • Accepts Insurance
  • Accepts Medicare Approved Payment

About GIAN CRUZ

This page provides the complete NPI Profile along with additional information for Gian Cruz, a provider established in San Antonio, Texas with a medical specialization in Physical Therapist and more than 4 years of experience. The healthcare provider is registered in the NPI registry with number 1558080556 assigned on August 2022. The practitioner's primary taxonomy code is 225100000X with license number 1367247 (TX). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI
1558080556
Provider Name
GIAN CARLO CRUZ PT
Gender
Male
Entity Type
Individual
Location Address
1901 BABCOCK RD SAN ANTONIO, TX 78229
Location Phone
(210) 680-5033
Location Fax
(210) 680-6094
Mailing Address
9821 CAMINO VILLA APT 512 SAN ANTONIO, TX 78254
Mailing Phone
(432) 940-4652
Medical School Name
OTHER
Graduation Year
2022
Is Sole Proprietor?
No
Enumeration Date
08-23-2022
Last Update Date
08-23-2022
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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

Physical Therapist

Taxonomy Code
225100000X
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.
1367247
License State
TX
Taxonomy Description
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Insurance Plans Accepted

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

  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - EPO
  • Bronze Simple Chronic Care CKM - EPO
  • Bronze Simple Diabetes - EPO
  • Gold Classic - EPO
  • Gold Classic Standard - EPO
  • Gold Elite - EPO
  • Silver Classic - EPO
  • Silver Classic Standard - EPO
  • Silver Simple PCP Saver - EPO

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

Medicare Participation & PECOS Enrollment Status

Gian 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.

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.

  • PECOS PAC ID: 4082081062

    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: I20221103002012

    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.

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.23 for a new patient copayment and $17.13 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 78229 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.92
  • Minimum New Patient Price $54.84
  • Maximum New Patient Price $166.88
  • Average New Patient Copayment $21.23
  • Minimum New Patient Copayment $13.71
  • Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $68.55
  • Minimum Established Patient Price $17.52
  • Maximum Established Patient Price $136.11
  • Average Established Patient Copayment $17.13
  • Minimum Established Patient Copayment $4.38
  • Maximum Established Patient Copayment $34.02

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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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 1558080556, we treat the final digit (6) 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

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
5
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
8
Unchanged
Pos 5
0
Doubled → 0
Pos 6
8
Unchanged
Pos 7
0
Doubled → 0
Pos 8
5
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
6
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 5 → 10 → 1 0 → 0 0 → 0 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 5 + 1 + 0 + 8 + 0 + 8 + 0 + 5 + 1 + 0 + 24 = 54

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

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1558080556.

Other Providers at the Same Location


The following 19 providers are registered at the same or a nearby location.

Pediatrics (Pediatric Cardiology)
1901 BABCOCK RD, SUITE 301
SAN ANTONIO, TX 78229
Pediatrics (Pediatric Cardiology)
1901 BABCOCK RD, SUITE 301
SAN ANTONIO, TX 78229
Pediatrics (Pediatric Cardiology)
1901 BABCOCK RD, SUITE 301
SAN ANTONIO, TX 78229
Dentist
1901 BABCOCK RD, STE. 101
SAN ANTONIO, TX 78229
Physical Medicine & Rehabilitation
1901 BABCOCK RD, #304
SAN ANTONIO, TX 78229
Physical Therapist
1901 BABCOCK RD, SUITE 204
SAN ANTONIO, TX 78229
Dentist
1901 BABCOCK RD, SUITE 101
SAN ANTONIO, TX 78229
Clinic/Center (Physical Therapy)
1901 BABCOCK RD, SUITE 204
SAN ANTONIO, TX 78229
Physical Therapist
1901 BABCOCK RD, SUITE 204
SAN ANTONIO, TX 78229
Physical Therapy Assistant
1901 BABCOCK RD, SUITE 304
SAN ANTONIO, TX 78229
Prosthetist
1901 BABCOCK RD
SAN ANTONIO, TX 78229
Preventive Medicine (Aerospace Medicine)
1901 BABCOCK RD, SUITE 200
SAN ANTONIO, TX 78229
Counselor (Mental Health)
1901 BABCOCK RD, STE. 102
SAN ANTONIO, TX 78229
Pediatrics (Pediatric Cardiology)
1901 BABCOCK RD, SUITE 301
SAN ANTONIO, TX 78229
Clinic/Center (Physical Therapy)
1901 BABCOCK RD, SUITE 204
SAN ANTONIO, TX 78229
Clinic/Center (Sleep Disorder Diagnostic)
1901 BABCOCK RD, #102
SAN ANTONIO, TX 78229
Physical Therapist
1901 BABCOCK RD
SAN ANTONIO, TX 78229
Counselor
1901 BABCOCK RD, SUITE 102
SAN ANTONIO, TX 78229
Prosthetic/Orthotic Supplier
1901 BABCOCK RD, SUITE 103
SAN ANTONIO, TX 78229

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1558080556, enumerated as an "individual" on August 23, 2022.

The provider is located at 1901 BABCOCK RD SAN ANTONIO, TX 78229 and the phone number is (210) 680-5033.

Physical Therapist with taxonomy code 225100000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas and Oscar. Please consult your insurance carrier or call the provider to verify.