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HELION W CRUZ M.D.
NPI 1871579409
Specialist in Hendersonville, TN

Active since December 15, 2005PECOS EnrolledAccepts Medicare Assignment
353 NEW SHACKLE ISLAND ROAD, SUITE 244C, HENDERSONVILLE, TN 37075(615) 826-0442(615) 826-0447 Get Directions Write a Review

NPPES record last updated: October 8, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Helion W Cruz M.d. NPPES

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

HELION W CRUZ M.D. (NPI 1871579409) is an individual specialist in Hendersonville, Tennessee, licensed in Tennessee (34215) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Sumner Regional Medical Center, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1871579409
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameHELION W CRUZCredential: M.D.
Location Address353 NEW SHACKLE ISLAND ROAD, SUITE 244CHendersonville, TN 37075-2380
Mailing Address353 New Shackle Island Rd., Suite 244cHendersonville, TN 37075-2380 · (615) 826-0442 · Fax (615) 826-0447
Phone(615) 826-0442
Fax(615) 826-0447
Sole ProprietorYes
Medical School CMSOtherGraduated 1996
Enumeration DateDecember 15, 2005
Last NPPES UpdateOctober 8, 2014
✔ NPI 1871579409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TN · 34215
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
353 NEW SHACKLE ISLAND ROAD, Hendersonville, TN 37075
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Other Identifiers 3

Medicare UPINH27515
Medicare ID-Type Unspecified3857581TN
Medicaid3857581TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Oscar Insurance Company.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

Helion W 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 ID1456317015
PECOS Enrollment IDI20090626000409
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 12

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.
338 services254 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This 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.
150 services137 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.
87 services87 patients
Needle measurement of electrical activity in arm or leg muscles, complete study 95886
This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.
60 services35 patients
Needle measurement of electrical activity in arm or leg muscles, limited study 95885
This procedure, known as an electromyography (EMG), involves placing tiny needles into your arm or leg muscles to measure their electrical activity. It's a limited study, meaning only specific muscles are tested. This helps identify any muscle or nerve dysfunction.
59 services30 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.
40 services40 patients

Hospital Affiliations CMS Care Compare 5

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

Sumner Regional Medical Center

Acute Care Hospitals · Gallatin, TN
1/5 CMS rating
OwnershipProprietary
CMS Certification Number440003
Location555 Hartsville PikeGallatin, TN 37066 · Sumner County
Emergency services Birthing friendly

Tristar Skyline Medical Center

Acute Care Hospitals · Nashville, TN
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440006
Location3441 Dickerson PikeNashville, TN 37207 · Davidson County
Emergency services

Tristar Northcrest Medical Center

Acute Care Hospitals · Springfield, TN
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number440065
Location100 Northcrest DriveSpringfield, TN 37172 · Robertson County
Emergency services Birthing friendly

Tristar Hendersonville Medical Center

Acute Care Hospitals · Hendersonville, TN
4/5 CMS rating
OwnershipProprietary
CMS Certification Number440194
Location355 New Shackle Island RdHendersonville, TN 37075 · Sumner County
Emergency services Birthing friendly

Macon Community Hospital

Critical Access Hospitals · Lafayette, TN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number441305
Location204 Medical DriveLafayette, TN 37083 · Macon County
Emergency services

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfStart: 5% · 20 patients
2%42 patients
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
84%96 patients4/55-star benchmark: 99%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
85%4,141 patients2/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
90%764 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
12%787 patients1/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%588 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
98%1,645 patients5/55-star benchmark: 97%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
5%1,525 patients1/55-star benchmark: 96%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%1,645 patients5/55-star benchmark: 100%
Secure Messaging
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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
21%1,645 patients1/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
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.
Lower rates are better for this measure.
Patients 2+: 2% · 776 patients
4%776 patients4/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
16%1,645 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers16 claims16 services$45.76 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers21 claims21 services$25.26 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 2

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

MISS CAROL LYNNE MEDLEY FNP-BC
Nurse Practitioner (Family)
353 NEW SHACKLE ISLAND ROAD, SUITE 140 C
HENDERSONVILLE, TN 37075
Sumner County (615) 826-5664
BLUEGRASS WOMEN'S HEALTH GROUP
Nurse Practitioner (Women's Health)
353 NEW SHACKLE ISLAND ROAD, SUITE 244C
HENDERSONVILLE, TN 37075
Sumner County (615) 826-1716

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 Helion Cruz's NPI number?

The NPI number for Helion Cruz is 1871579409. It was assigned to this individual provider in the NPPES registry on December 15, 2005.

Where is Helion Cruz located?

Helion Cruz practices at 353 New Shackle Island Road Suite 244C, Hendersonville, TN 37075. The listed phone number is (615) 826-0442.

What is Helion Cruz's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Helion Cruz enrolled in Medicare?

Yes. Helion 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 Helion Cruz accept?

Health plans from BlueCross BlueShield of Tennessee and Oscar Insurance Company list Helion 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.

Is Helion Cruz affiliated with any hospitals?

According to CMS data, Helion Cruz is affiliated with Sumner Regional Medical Center, Tristar Skyline Medical Center, Tristar Northcrest Medical Center, Tristar Hendersonville Medical Center and Macon Community Hospital.

When was this NPI record last updated?

The NPPES record for Helion Cruz was last updated on October 8, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.