Individual provider Active NPI

Shannon M Cruz, APRN-FNP-C

  • Family Nurse Practitioner
  • Hooksett, NH
National Provider Identifier
1003516188
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
072754-23 Issued in NH
Practice address
7 Cinemagic Way
Hooksett, NH 03106-1088
Phone
(603) 782-5112
Fax
(603) 932-2983
NPI assigned
Mar 7, 2023
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 072754-23 NH Primary

Addresses

Primary practice location

7 Cinemagic Way
Hooksett, NH 03106-1088

Mailing address

10 Ferry St Ste 302
Concord, NH 03301-5081

Other practice location 1

565 Amherst St
Nashua, NH 03063-1048
Phone (603) 578-3347

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230404002401 NH Practitioner - Nurse Practitioner 2062887045 Reassigns benefits to 3 organizations
I20260617002276 MA Practitioner - Nurse Practitioner 2062887045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Care of New Hampshire LLCGroup PAC ID 9133506272, 17 clinicians
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

20 Chester Rd
Derry, NH 03038-1636
Phone (718) 298-4375

565 Amherst St
Nashua, NH 03063-1048
Phone (603) 578-3347

Merit-based Incentive Payment System (MIPS)

Final score
99.02 of 100Reported as group
Quality
90.74
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care of New Hampshire LLC CurrentSince Sep 1, 2024 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince May 1, 2024 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince May 1, 2024 Accepting new patients
Convenientmd - FFS UC LLC Current Accepting new patients
Clearchoicemd Primary Care PLLC Past Accepting new patients

Locations

3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700

20 Chester Rd
Derry, NH 03038
Phone (603) 432-3801

2 Dobson Way
Merrimack, NH 03054
Phone (603) 471-6069

565 Amherst St
Nashua, NH 03063
Phone (603) 573-3477

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1003516188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FERRY ST STE 302",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033015081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CINEMAGIC WAY",
            "city": "HOOKSETT",
            "state": "NH",
            "postal_code": "031061088",
            "telephone_number": "603-782-5112",
            "fax_number": "603-932-2983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "565 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Nashua",
            "state": "NH",
            "postal_code": "030631048",
            "country_code": "US",
            "telephone_number": "603-578-3347",
            "fax_number": "603-578-3387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "APRN-FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-07",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "072754-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hooksett, NH

Sources for this page

Verify at the official NPI Registry.