Organization Active NPI

Luis R. Cruz, M.D., P.C.

  • Primary Care Clinic/Center
  • New Haven, CT
National Provider Identifier
1043522360
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
016660 Issued in CT
Legal business name
LUIS R. CRUZ, M.D., P.C.
Practice address
1552 Chapel St
New Haven, CT 06511-4251
Phone
(203) 624-2117
NPI assigned
Jul 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Authorized official

Name
Luis R Cruz, M.D.
Title
President
Phone
(203) 624-2117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 016660 CT Primary

Addresses

Primary practice location

1552 Chapel St
New Haven, CT 06511-4251

Mailing address

1552 Chapel St
New Haven, CT 06511-4251
Phone (203) 624-2117

Other identifiers 2

IdentifierTypeStateIssuer
001166602MedicaidCT
010016660CT01OtherCTANTHEM BC/BS

National Provider Directory

National Provider Directory

Locations

1552 Chapel St
New Haven, CT 06511
Phone (203) 624-2117

NPI Registry JSON

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1043522360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114251",
            "telephone_number": "203-624-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114251",
            "telephone_number": "203-624-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS R. CRUZ, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-02",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-624-2117",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CT",
            "license": "016660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001166602",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "010016660CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.