MR. REYNALDO JR. DE LA CRUZ – Family Nurse Practitioner, NPI 1104630003

MR. REYNALDO JR. DE LA CRUZ is a healthcare provider. based in San antonio, Texas. specializing in NURSE PRACTITIONER. They hold a License No. F02250107 (VA). The NPI Number for MR. REYNALDO JR. DE LA CRUZ is 1104630003

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
MR. REYNALDO JR. DE LA CRUZ
NPI
1104630003
Phone
(210) 846-6258
Address
10210 SUNSET FLD
Enumeration Date
3 February 2025
Last Update Date
3 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3202743737
Graduation Year
2023 (3 years ago)
PAC ID
8921518739
Group Practice PAC ID
8325263734
Professional Enrollment ID
I20250613002357
Address ID
VA220033450AN6700XPIKE300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for MR. REYNALDO JR. DE LA CRUZ

  • 10210 SUNSET FLD

    SAN ANTONIO, TX 782452695

    Phone: (210) 846-6258

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250610004300INurse PractitionerMDTBD
I20250613002357INurse PractitionerDCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78245)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8325263734View full group profile
NameSpecialtyState
Nurse PractitionerOH
Nurse PractitionerOH
-OH
Nurse PractitionerIN
Nurse PractitionerIN
Nurse PractitionerKY
-OH
Nurse PractitionerMD
Nurse PractitionerIN
Nurse PractitionerIN

Reviews

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Frequently asked questions

What unique ID ties claims to MR. REYNALDO JR. DE LA CRUZ?
NPI 1104630003 is assigned to MR. REYNALDO JR. DE LA CRUZ under the national enumeration system.
Is MR. REYNALDO JR. DE LA CRUZ currently active in the NPI registry?
CMS-published data lists MR. REYNALDO JR. DE LA CRUZ as an active registrant.
Does MR. REYNALDO JR. DE LA CRUZ list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for MR. REYNALDO JR. DE LA CRUZ. Clinical services aligned with this taxonomy classification.
Where is MR. REYNALDO JR. DE LA CRUZ's primary listing?
We display San Antonio, Texas because that is what the record indicates for MR. REYNALDO JR. DE LA CRUZ.
Is MR. REYNALDO JR. DE LA CRUZ a real provider?
This page reflects official NPPES data for NPI 1104630003. Always confirm identity and privileges with the practice and licensing boards.

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