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

Q: 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.

Q: 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.

Q: 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.

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: October 25, 2026.

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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

Phone(636) 344-2014

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

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Other Identifiers 1

Medicaid1669460655MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

Medicare enrollment records show Rafael De La Cruz reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Heights Medical Group, Sc

25 mi

Internal Medicine

670 MASON RIDGE CENTER DR, STE 300
Saint Louis, MO 63141

Reassigned Medicare billing, Illinois and Missouri enrollments
Also billed through NPI 1679503668 (Missouri)
507 clinicians in this Medicare group

NPI 1811392210 (314) 996-7644

Parkland Health Center

79 mi

General Practice

1101 W LIBERTY ST
Farmington, MO 63640

Reassigned Medicare billing, Missouri enrollment
71 clinicians in this Medicare group

NPI 1922016112 (573) 756-6451

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Memorial Hospital

Acute Care Hospitals · Belleville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140185

Location4500 Memorial DriveBelleville, IL 62226 · St. Clair 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

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.

MINDY MARIE FARAONE FNP

Nurse Practitioner (Family)