Yenny A Cruz, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

P06160 Issued in NY

Practice address

500 Holly Springs Rd
Holly Springs, NC 27540-6204

Phone

(919) 762-5113

NPI assigned

Jul 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: yenny.cruz.1@23054.direct.athenahealth.com

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.

• Advance Community Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Raleigh, NC
  • NPI 1245223783
  Medicare reassignment NPD
• Advance Community Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Apex, NC
  • NPI 1598751463
  NPD (past)

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1114449550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 LEYLAND CYPRESS LN",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262574",
            "telephone_number": "347-488-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HOLLY SPRINGS RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275406204",
            "telephone_number": "919-762-5113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1827 Madison St Apt 3L",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NY",
            "postal_code": "113853709",
            "country_code": "US",
            "telephone_number": "347-488-2867",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "374 Stockholm St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112374006",
            "country_code": "US",
            "telephone_number": "718-963-7708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "YENNY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2022-02672",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "P06160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P06160",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda J Cornish, MSW, LCSW
• Alleigh Cotten
• Meghan Theresa Cowles, FNP
• Lindsey Crilly, MA, LCMHCA, NCC
• Haley Crumpler, MSW, LCSWA
• Hannah Cunnup
• Marcus Charles Curry, DDS
• Theresa Hackeling Curzan, M.D.
• Joshua Da Silva
• Christopher John Dahm, PT

• Pediatrics Physician in Holly Springs, NC
• Providers in Holly Springs, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.