RAFAEL DE LA CRUZ MD
NPI 1669460655
Internal Medicine - Infectious Disease in Alton, IL

Active since October 12, 2005PECOS EnrolledAccepts Medicare Assignment
4 MEMORIAL DR STE 230B, ALTON, IL 62002(636) 344-2014(314) 747-1476 Get Directions Write a Review

NPPES record last updated: February 26, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Rafael De La Cruz Md NPPES

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

RAFAEL DE LA CRUZ MD (NPI 1669460655) is an individual infectious disease provider in Alton, Illinois, licensed in Illinois (036-108921) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Alton Memorial Hospital, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1669460655
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameRAFAEL DE LA CRUZCredential: MD
Location Address4 MEMORIAL DR STE 230BAlton, IL 62002-6705
Mailing Address670 Mason Ridge Center Dr, Ste. 300Saint Louis, MO 63141-8573 · (636) 344-2014 · Fax (314) 747-1476
Fax(314) 747-1476
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateOctober 12, 2005
Last NPPES UpdateFebruary 26, 2021
NPPES CertifiedFebruary 26, 2021
NPI 1669460655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
Licenses Licensed in IL · 036-108921 Licensed in MO · 2008007441
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
4 MEMORIAL DR STE 230B, Alton, IL 62002

Other Identifiers 1

Medicaid1669460655MO

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

Rafael De La Cruz Md 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 ID6204873292
PECOS Enrollment IDI20050412000220, I20081017000504
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 10

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 of tissue from wound, 20.0 sq cm or less 97597
This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.
369 services76 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
301 services246 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
190 services112 patients
Removal of tissue from wound, each additional 20.0 sq cm 97598
This procedure involves the careful removal of damaged tissue from a wound, typically beyond an initial 20.0 sq cm. This is done to promote healing, prevent infection, and improve the function and appearance of the area surrounding the wound.
136 services20 patients
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.
123 services89 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
91 services50 patients

Hospital Affiliations CMS Care Compare 5

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

Alton Memorial Hospital

Acute Care Hospitals · Alton, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140002
LocationOne Memorial DriveAlton, IL 62002 · Madison County
Emergency services Birthing friendly

Barnes Jewish Hospital

Acute Care Hospitals · Saint Louis, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number260032
LocationOne Barnes-Jewish Hospital PlazaSaint Louis, MO 63110 · St. Louis City County
Emergency services Birthing friendly

Missouri Baptist Medical Center

Acute Care Hospitals · Town And Country, MO
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260108
Location3015 N Ballas RdTown And Country, MO 63131 · St. Louis County
Emergency services Birthing friendly

Parkland Health Center

Acute Care Hospitals · Farmington, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260163
Location1101 W LibertyFarmington, MO 63640 · St. Francois County
Emergency services Birthing friendly

Progress West Hospital

Acute Care Hospitals · O Fallon, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260219
Location2 Progress Point PkwyO Fallon, MO 63368 · St. Charles County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62002 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
$131.14 typical visit price
range $56.28 – $173.35
Typical copayment $32.78 (range $14.07 – $43.33)
Most-billed visit code 99204
Established Patient
$99.71 typical visit price
range $17.51 – $139.99
Typical copayment $24.92 (range $4.37 – $34.99)
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196
DME-Medical/Surgical Supplies · category DA023N
3 suppliers12 claims268 services$7.10 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

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

Nurse Practitioner (Family)
4 MEMORIAL DR STE 230B
ALTON, IL 62002
Otolaryngology (Facial Plastic Surgery)
4 MEMORIAL DR STE 230B
ALTON, IL 62002
Nurse Practitioner (Family)
4 MEMORIAL DR STE 230B
ALTON, IL 62002
Surgery
4 MEMORIAL DR STE 230B
ALTON, IL 62002
Internal Medicine (Gastroenterology)
4 MEMORIAL DR STE 230B
ALTON, IL 62002

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 Rafael De La Cruz's NPI number?

The NPI number for Rafael De La Cruz is 1669460655. It was assigned to this individual provider in the NPPES registry on October 12, 2005.

Where is Rafael De La Cruz located?

Rafael De La Cruz practices at 4 Memorial Dr Ste 230B, Alton, IL 62002. The listed phone number is (636) 344-2014.

What is Rafael De La Cruz's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Rafael De La Cruz enrolled in Medicare?

Yes. Rafael De La 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.

Is Rafael De La Cruz affiliated with any hospitals?

According to CMS data, Rafael De La Cruz is affiliated with Alton Memorial Hospital, Barnes Jewish Hospital, Missouri Baptist Medical Center, Parkland Health Center and Progress West Hospital.

When was this NPI record last updated?

The NPPES record for Rafael De La Cruz was last updated on February 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.