Active NPI
Luis R. Cruz, M.D., P.C.
- Primary Care Clinic/Center
- New Haven, CT
National Provider Identifier
1043522360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- License
- 016660
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001166602 | Medicaid | CT | |
| 010016660CT01 | Other | CT | ANTHEM BC/BS |
National Provider Directory
National Provider DirectoryLocations
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.