Individual provider Active NPI

Felipe Cruz, LDO

  • Optician
  • Glenville, NY
National Provider Identifier
1104669571
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
009386 Issued in NY
Practice address
200 Dutch Meadows LN
Glenville, NY 12302-3546
Phone
(518) 344-7634
Fax
(518) 344-7636
NPI assigned
Jun 14, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 009386 NY Primary

Addresses

Primary practice location

200 Dutch Meadows LN
Glenville, NY 12302-3546

Mailing address

200 Dutch Meadows LN
Glenville, NY 12302-3546
Phone (518) 344-7634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1104669571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DUTCH MEADOWS LN",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123023546",
            "telephone_number": "518-344-7634",
            "fax_number": "518-344-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DUTCH MEADOWS LN",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123023546",
            "telephone_number": "518-344-7634",
            "fax_number": "518-344-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "FELIPE",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "009386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.