MANUEL A. CRUZ M.D.
NPI 1720132988
Internal Medicine - Nephrology in Manati, PR
NPI Status: Active since January 23, 2007
Contact Information
URB ATENAS HERNANDEZ CARRION
MANATI, PR
ZIP 00674
Phone: (787) 854-4120
Fax: (787) 884-5489
- Individual
- Male
- Years of Experience 52
- Internal Medicine
- Nephrology
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About MANUEL CRUZ
This page provides the complete NPI Profile along with additional information for Manuel Cruz, an internist established in Manati, Puerto Rico with a medical specialization in Internal Medicine, focusing in nephrology and more than 52 years of experience. The healthcare provider is registered in the NPI registry with number 1720132988 assigned on January 2007. The practitioner's primary taxonomy code is 207RN0300X with license number 5004 (PR). The provider is registered as an individual and his NPI record was last updated 5 years ago.
- NPI
- 1720132988
- Provider Name
- MANUEL A. CRUZ M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- URB ATENAS HERNANDEZ CARRION MANATI, PR 00674
- Location Phone
- (787) 854-4120
- Location Fax
- (787) 884-5489
- Mailing Address
- PO BOX 1662 MANATI, PR 00674
- Mailing Phone
- (787) 854-4120
- Mailing Fax
- (787) 884-5489
- Medical School Name
- OTHER
- Graduation Year
- 1974
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-23-2007
- Last Update Date
- 07-20-2020
- Code Navigator
An internist like Manuel Cruz is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
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
Internal Medicine Nephrology
- Taxonomy Code
- 207RN0300X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 5004
- License State
- PR
- Taxonomy Description
- An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Medicare Participation & PECOS Enrollment Status
Manuel 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.
Manuel Cruz is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
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.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4688584550
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: I20071228000093
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.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Unknown
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period (HCPCS:Q0512)
2 DME suppliers used 12 Medicare Claims 15 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Dialysis services, 2-3 physician visits per month (20 years or older)
Dialysis services, 4 or more physician visits per month (20 years or older)
Established patient office or other outpatient visit, 20-29 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Hemodialysis procedure with physician evaluation
Initial hospital inpatient care per day, typically 50 minutes
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
This service was performed 20 times for 11 patientsDialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
This service was performed 158 times for 24 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 47 times for 32 patientsFollow-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.
This service was performed 184 times for 23 patientsHemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
This service was performed 74 times for 12 patientsInitial 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.
This service was performed 11 times for 11 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.66 for a new patient copayment and $25.06 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 00674 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $130.65
- Minimum New Patient Price $56.86
- Maximum New Patient Price $172.44
- Average New Patient Copayment $32.66
- Minimum New Patient Copayment $14.21
- Maximum New Patient Copayment $43.11
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.24
- Minimum Established Patient Price $18.24
- Maximum Established Patient Price $140.44
- Average Established Patient Copayment $25.06
- Minimum Established Patient Copayment $4.56
- Maximum Established Patient Copayment $35.11
* 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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Clinical Information Reconciliation | 73% | 534 |
| For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation. The MIPS eligible clinician must implement clinical information reconciliation for the following three clinical information sets: (1) Medication. Review of the patient's medication, including the name, dosage, frequency, and route of each medication. (2) Medication allergy. Review of the patient's known medication allergies. (3) Current Problem list. Review of the patient's current and active diagnoses. | ||
| Closing the Referral Loop: Receipt of Specialist Report | 55% | 101 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred | ||
| Collection and follow-up on patient experience and satisfaction data on beneficiary engagement | Yes | N/A |
| Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan. | ||
| Diabetes: Foot Exam | 65% | 546 |
| The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year | ||
| e-Prescribing | 100% | 2175 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Patient-Specific Education | 92% | 540 |
| The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 99% | 1451 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 79% | 29 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide Education Opportunities for New Clinicians | Yes | N/A |
| MIPS eligible clinicians acting as a preceptor for clinicians-in-training (such as medical residents/fellows, medical students, physician assistants, nurse practitioners, or clinical nurse specialists) and accepting such clinicians for clinical rotations in community practices in small, underserved, or rural areas. | ||
| Provide Patient Access | 71% | 540 |
| For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology. | ||
| Request/Accept Summary of Care | 5% | 475 |
| For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an electronic summary of care document. | ||
| Secure Messaging | 63% | 540 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative). | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Send a Summary of Care | 72% | 39 |
| For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2) electronically exchanges the summary of care record. | ||
| Use of High-Risk Medications in the Elderly | 1% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 944 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Manuel Cruz is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| MANATI MEDICAL CENTER DR OTERO LOPEZ | CARR 668 CALLE HERNANDEZ CARRION URB ATENAS MANATI, PR 00674 | (787) 621-3700 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 2 | 0 | 1 | 3 | 2 | 9 | 8 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 4 | 0 | 2 | 3 | 4 | 9 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 4 + 0 + 2 + 3 + 4 + 9 + 1 + 6 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1720132988 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
CRUZ SOTO & PADILLA, NEFROLOGOS, CSP
Internal Medicine
(Nephrology)
URB ATENAS HERNANDEZ CARRION
MANATI, PR
ZIP 00674
LOURDES S. PENA-DE LA VEGA M.D.
Internal Medicine
(Nephrology)
URB ATENAS HERNANDEZ CARRION
MANATI, PR
ZIP 00674
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720132988, enumerated as an "individual" on January 23, 2007.
The provider is located at URB ATENAS HERNANDEZ CARRION MANATI, PR 00674 and the phone number is (787) 854-4120.
Internal Medicine with taxonomy code 207RN0300X and a focus in Nephrology.
Manuel Cruz is affiliated with: MANATI MEDICAL CENTER DR OTERO LOPEZ.
