Individual provider Active NPI

Jersain Alberto Cruz, ARNP

  • Family Nurse Practitioner
  • Vero Beach, FL
National Provider Identifier
1043412059
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9229979 Issued in FL
Practice address
1400 27TH St
Vero Beach, FL 32960-0303
Phone
(772) 257-8224
Fax
(772) 213-3157
NPI assigned
Jun 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 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 APRN9229979 FL Primary

Addresses

Primary practice location

1400 27TH St
Vero Beach, FL 32960-0303

Mailing address

1545 9TH St SW
Vero Beach, FL 32962-4312
Phone (772) 257-8224

Other identifiers 2

IdentifierTypeStateIssuer
APRN9229979OtherFLMEDICAL LICENSE
120359000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20071129000139 FL Practitioner - Nurse Practitioner 3870682834 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Coast Community Health Inc CurrentSince Dec 11, 2023 Accepting new patients
Treasure Coast Community Health Inc CurrentSince Dec 11, 2023 Accepting new patients
Forest Hill Medical Group LLC CurrentSince Oct 1, 2022 Accepting new patients
Post Acute Care Leaders-Florida LLC CurrentSince Feb 1, 2023 Accepting new patients
Forest Hill Physician Group, Inc. PastSince Oct 1, 2022 Accepting new patients
Osler Medical Inc Past Accepting new patients
Osler Hma Medical Group LLC Past Accepting new patients

Locations

2240 W Woolbright Rd
Ste 317
Boynton Beach, FL 33426
Phone (561) 200-0047

12196 County Road 512
Fellsmere, FL 32948
Phone (561) 571-8828

220 Sierra Dr
North Miami Beach, FL 33179
Phone (305) 653-8427

3098 Forest Hill Blvd
Unit 1
Palm Springs, FL 33406
Phone (561) 968-7600

3098 Forest Hill Blvd
Palm Springs, FL 33406
Phone (561) 968-7600

787 37th St
Ste E200
Vero Beach, FL 32960
Phone (772) 567-3003

1400 27th St
Vero Beach, FL 32960

1545 9th St SW
Vero Beach, FL 32962
Phone 77225782241908

925 North Point Pkwy
Ste 425
Alpharetta, GA 30005
Phone (678) 593-3332

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDCBCD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1043412059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 9TH ST SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329624312",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 27TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329600303",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JERSAIN",
        "middle_name": "ALBERTO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9229979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "APRN9229979",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120359000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.