NPIMap

Organization Active NPI

Victor M. Cruz MD, P.C.

Doing business as Cruz Clinic

  • Psychiatry Physician
  • Livonia, MI
National Provider Identifier
1023036514
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
VICTOR M. CRUZ MD, P.C.
Doing business as
Cruz Clinic
Practice address
17177 N Laurel Park Dr
Suite 131
Livonia, MI 48152-2693
Phone
(734) 462-3210
Fax
(734) 462-1024
NPI assigned
Jul 17, 2006
Last updated
Jan 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Authorized official

Name
Dr. Victor Cruz, MDNPI 1285669325
Title
President
Phone
(734) 462-3210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

17177 N Laurel Park Dr
Suite 131
Livonia, MI 48152-2693

Mailing address

17177 N Laurel Park Dr
Suite 131
Livonia, MI 48152-2693
Phone (734) 462-3210

Other names 1

  • Cruz Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081202000484 MI Part B Supplier - Clinic/Group Practice 3375604952 Receives reassigned benefits from 59 practitioners
Practice locations: Livonia, MI

National Provider Directory

National Provider Directory

Locations

17177 Laurel Dr
Ste 131
Livonia, MI 48152
Phone (313) 462-3210

17177 N Laurel Park Dr
Ste 131
Livonia, MI 48152
Phone (734) 462-3210

Practitioners & affiliated clinicians

Practitioners 78

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 78

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1023036514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17177 N LAUREL PARK DR",
            "address_2": "SUITE 131",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522693",
            "telephone_number": "734-462-3210",
            "fax_number": "734-462-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17177 N LAUREL PARK DR",
            "address_2": "SUITE 131",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522693",
            "telephone_number": "734-462-3210",
            "fax_number": "734-462-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR M. CRUZ MD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-462-3210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cruz Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.