Individual provider Active NPI

Wilhelmina P Cruz-Vetrano, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Brooklyn, NY
National Provider Identifier
1104861186
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
179726 Issued in NY
Practice address
374 Stockholm St
Brooklyn, NY 11237-4006
Phone
(718) 963-7512
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 179726 NY Primary

Addresses

Primary practice location

374 Stockholm St
Brooklyn, NY 11237-4006

Mailing address

374 Stockholm Street
Pathology Dept
Brooklyn, NY 11237
Phone (718) 963-7512

Other practice location 1

809 Turnpike Ave
Pathology Dept
Clearfield, PA 16830-1232
Phone (814) 765-5341 ext. 2553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160718000042 NY Practitioner - Pathology 0547241283 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyckoff Professional Medical Services PCGroup PAC ID 6406748607, 154 clinicians

Practice addresses (Care Compare)

374 Stockholm St
Brooklyn, NY 11237-4006
Phone (718) 963-7266

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
179726NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Professional Medical Services, PC Anatomic Pathology & Clinical Pathology CurrentSince Jun 1, 2018 Accepting new patients
Garden City Colon & Rectal Surgical Practice, P.C. CurrentSince May 1, 2016 Accepting new patients
North Shore-Lij Medical PC CurrentSince Sep 12, 2018 Accepting new patients
Clearfield Pathology Associates, PC PastSince Aug 27, 2004 Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1075 Franklin Ave
Garden City, NY 11530
Phone (516) 248-7733

300 Community Dr
Fl 1
Manhasset, NY 11030
Phone (516) 562-2252

27005 76th Ave
#222
New Hyde Park, NY 11040
Phone (718) 470-7260

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1104861186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM STREET",
            "address_2": "PATHOLOGY DEPT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11237",
            "telephone_number": "718-963-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-963-7512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 Turnpike Ave",
            "address_2": "Pathology Dept",
            "address_purpose": "LOCATION",
            "city": "Clearfield",
            "state": "PA",
            "postal_code": "168301232",
            "country_code": "US",
            "telephone_number": "814-765-5341 x2553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ-VETRANO",
        "first_name": "WILHELMINA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "179726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.