Carolyn De La Cruz
NPI 1356315956 · Specialist · Pittsburgh, PA
Enrolled with Medicare as Practitioner - Plastic and Reconstructive Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Carolyn De La Cruz is a Specialist provider in Pittsburgh, PA (NPI 1356315956).
Provider details
- NPI number
- 1356315956
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- MD424957 (PA)
Specialties & taxonomies
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
20 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
122 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Straightforward Medical Decision Making, If Using Time, 10 Minutes Or More99212 | 71 | $53 |
| New Patient Office Or Other Outpatient Visit With Low Level of Medical Decision Making, If Using Time, 30 Minutes Or More99203 | 32 | $105 |
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 19 | $84 |
Typical Medicare-allowed amounts for these services range $53–$105 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 1 distinct drug on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Cephalexin | 21 | 17 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$1,491 across 4 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-02-13
- Last updated
- 2021-03-25
Frequently asked questions
- What is Carolyn De La Cruz's NPI number?
- Carolyn De La Cruz's National Provider Identifier (NPI) is 1356315956, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Carolyn De La Cruz's specialty?
- Carolyn De La Cruz is listed in the NPPES registry with a primary specialty of Specialist (Other Service Providers).
- Where is Carolyn De La Cruz located?
- Carolyn De La Cruz's practice location on file with NPPES is 300 Halket St, Pittsburgh, PA 15213-3108.
- What is Carolyn De La Cruz's phone number?
- The practice phone number listed in the NPPES registry for Carolyn De La Cruz is (412) 648-9670.
- Does Carolyn De La Cruz accept Medicare?
- Carolyn De La Cruz is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Carolyn De La Cruz's NPI active?
- Yes — Carolyn De La Cruz's NPI (1356315956) is active in the NPPES registry as of the last update on 2021-03-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.