SEBASTIAN ALEJANDRO CRUZ (NPI# 1821617499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821617499 |
| Entity Type | Individual |
| Full Name | SEBASTIAN ALEJANDRO CRUZ |
| Practice Address |
77 Nealy Blvd Hampton VA 23665-2023 |
| Practice Telephone | 7404617038 |
| Mailing Telephone | 7577645788 |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2020-04-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962898 | Sebastian Andres Cruz | Internal Medicine | Northshore University Healthsystem, Off of Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2020-05-06 |
| Street Address |
77 NEALY BLVD |
| City | HAMPTON |
| State | VA |
| Zip Code | 23665-2023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730547258 | Heidi Marie Blaski | Registered Nurse | 77 Nealy Blvd, Hampton, VA 23665-2023 | 2016-01-29 |
| 1063642957 | Cornelius R Peterson | Anesthesiology | 77 Nealy Blvd, Langley Afb Hospital, Anesthesiology Room 2110, Hampton, VA 23693 | 2009-07-25 |
| 1750568234 | Fredilyn M Lipata | Pathology | 77 Nealy Blvd, Hampton, VA 23665-2023 | 2008-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228938 | Mai Stern | Student in an Organized Health Care Education/Training Program | Langley Afb Dental Clinic, Hampton, VA 23665 | 2020-06-05 |
| 1386273449 | Nicholas Thomas Nelson | Military Health Care Provider | 633d Medical Group, 76 Nealy Ave, Building #92, Apo, AA 23665 | 2020-04-02 |
| 1316574809 | Kimberly C Easterling | Student in an Organized Health Care Education/Training Program | 76 Nealy Avenue, Joint Base Langley-eustis, Hampton, VA 23665 | 2020-03-24 |
| 1851950026 | Erin Leigh Baldridge | Dentist | Joint Base Langley Eustis Dental Clinic, 76 Nealy Ave, Apo, AA 23665 | 2019-06-11 |
| 1669950739 | Anthony Interrante IIi | Nurse Practitioner | Usaf Hospital Langley, 77 Nealy Avenue, Hampton, VA 23665 | 2018-08-01 |
| 1588189310 | Stacey Marie Jackson | Psychologist | 11 Nealy Blvd, Hampton, VA 23665 | 2017-08-14 |
| 1285062216 | Michael John Vietti | Physician Assistant | 633 Mdg 77 Nealy Ave, Yorktown, VA 23665 | 2013-10-30 |
| 1396182234 | Micaela Jane Dagucon | General Practice | 633d Mdg/sghc, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665 | 2013-06-02 |
| 1912212051 | Michele Leigh Shirley | Pharmacist | 633d Medical Group Hospital, 77 Nealy Avenue, Building 257, Joint Base Langley-eustis, VA 23665 | 2010-08-13 |
| 1497915219 | Stephen Warren Porter | Dentist | 76 Nealy Ave, 1st Dental Squadron/sgd, Langley Air Force Base, VA 23665 | 2008-06-16 |
| Find all providers in zip 23665 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063851616 | Alina J Elliott | Military Health Care Provider | 119 Kincaid Ln, Hampton, VA 23666-5401 | 2013-06-17 |
| 1821337346 | Stefan Langley | Military Health Care Provider | 212 Apollo Way, Hampton, VA 23665-2492 | 2013-02-04 |
| 1790041192 | Ferdinand Nmi Makabata | Military Health Care Provider | 1406 Hardy Cash Dr, Hampton, VA 23666-2434 | 2012-04-10 |
| 1053688416 | Thomas Garrett Cook | Military Health Care Provider | 384 Watts Ave, Hampton, VA 23665-1822 | 2011-11-29 |
| 1750614723 | Joan A Sanchez | Military Health Care Provider | 1113 Aberdeen Rd, Hampton, VA 23666-4601 | 2009-09-09 |
| 1386252872 | Joseph John Mieding | Military Health Care Provider | 77 Nealy Ave, Hampton, VA 23665-2040 | 2020-07-21 |
| 1487270195 | Juan Rafael Rodriguez | Military Health Care Provider | 77 Nealy Ave, Hampton, VA 23665-2040 | 2020-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952878365 | Justin Felix | Military Health Care Provider | 4747 W Braddock Rd Apt 3, Alexandria, VA 22311-4722 | 2018-10-24 |
| 1629555792 | Christopher R Bowlds | Military Health Care Provider | 3477 S Utah St, Arlington, VA 22206-1943 | 2018-07-23 |
| 1053809491 | James Miller | Military Health Care Provider | 716 Whisperwood Dr, Newport News, VA 23602-4954 | 2018-05-01 |
| 1225464837 | Stephen Mitchell Harris | Military Health Care Provider | 49 Spruce St, Pcs Box 1000, Langley Afb, VA 23665-2800 | 2013-09-16 |
| 1104259522 | Antoine Lamont Smith Sr. | Military Health Care Provider | 1260 Shotgun Rd, Chesapeake, VA 23322-4512 | 2013-08-21 |
| 1598032955 | Ann Marie Summerrise | Military Health Care Provider | 102 Chippenham Dr Apt H, Yorktown, VA 23693-2843 | 2011-11-29 |
| 1225263320 | Eddie C Webb | Military Health Care Provider | 162 Dodd Blvd, Ste 100, Langley Afb, VA 23665-1916 | 2009-05-19 |
| 1669606802 | Angie Cain | Military Health Care Provider | 633 Medical Group, 77 Neally Ave, Joint Base Langley-eustis, VA 23665-2040 | 2009-05-01 |
| 1760691547 | Donald Paul Highley Jr. | Military Health Care Provider | Uss James E, Williams (ddg 95), Norfolk, VA 09575-1204 | 2007-05-21 |
| 1255548491 | Daniel Wayne Vanskyhawk II | Military Health Care Provider | 414 Concord Rd, Portsmouth, VA 23701-2231 | 2007-05-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.