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MARIO CRUZ JR. M.D.
NPI 1962628677
Pediatrics in Philadelphia, PA

Active since April 18, 2007PECOS Enrolled
5501 OLD YORK RD, PHILADELPHIA, PA 19141(215) 456-7170(215) 456-4923 Get Directions Write a Review

NPPES record last updated: August 16, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 16, 2024, Mar 17, 2018, Mar 24, 2017 (3 updates tracked since 2017).

About Mario Cruz Jr. M.d. NPPES

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

MARIO CRUZ JR. M.D. (NPI 1962628677) is an individual pediatrics provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD432064) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962628677
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameMARIO CRUZ JR.Credential: M.D.
Location Address5501 OLD YORK RDPhiladelphia, PA 19141-3018
Mailing Address5501 Old York RdPhiladelphia, PA 19141-3018 · (215) 456-7170 · Fax (215) 456-4923
Phone(215) 456-7170
Fax(215) 456-4923
Sole ProprietorYes
Enumeration DateApril 18, 2007
Last NPPES UpdateAugust 16, 20243 updates tracked since enumeration
NPPES CertifiedAugust 16, 2024
✔ NPI 1962628677 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in PA · MD432064
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
5501 OLD YORK RD, Philadelphia, PA 19141
Open in Google Maps ↗

Other Identifiers 1

Medicaid1020627490005PA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mario Cruz Jr. M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Mario Cruz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Einstein Practice Plan, Inc
Same address
Medical Toxicology
5501 OLD YORK RD
Philadelphia, PA 19141
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 1,205 clinicians in this Medicare group
NPI 1396327151 (215) 456-6666

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19141 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
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

Other Providers at the Same Location NPPES 20

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

KENNETH KLECKNER MD
Emergency Medicine
5501 OLD YORK RD, EINSTEIN MEDICAL CENTER - PHILADELPHIA
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-6679
MS. AMMAN HASSAN MD
Pediatrics
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-3810
TAYLOR NICOLE THOMPSON PA-C
Physician Assistant (Medical)
5501 OLD YORK RD, KORMAN BUILDING SUITE 202
PHILADELPHIA, PA 19141
Philadelphia County (215) 254-2630
STEPHEN RYAN CHEN
Orthopaedic Surgery
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. DHRUV SHARMA MD
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
TIMOTHY DANIEL GARDNER DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. JONATHAN THOMAS LUCIANI DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
ASHIKA KAPOOR MD
Psychiatry & Neurology (Psychiatry)
5501 OLD YORK RD
PHILA, PA 19141
Philadelphia County (215) 456-8103

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 Mario Cruz's NPI number?

The NPI number for Mario Cruz is 1962628677. It was assigned to this individual provider in the NPPES registry on April 18, 2007.

Where is Mario Cruz located?

Mario Cruz practices at 5501 Old York Rd, Philadelphia, PA 19141. The listed phone number is (215) 456-7170.

What is Mario Cruz's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mario Cruz enrolled in Medicare?

Yes. Mario Cruz is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mario Cruz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mario Cruz reassigns Medicare benefits to Einstein Practice Plan, Inc (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mario Cruz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mario Cruz was last updated on August 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.