Individual provider Active NPI

Enrique Cruz, LCSW,LICSW, PMHNP,RN

  • Psychiatry Physician
  • Burlington, MA
National Provider Identifier
1124595038
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
RN2390444 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-4063
Phone
(781) 744-8000
NPI assigned
Oct 29, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 093513 NY
Clinical Social Worker 1041C0700X 125306 MA
Psychiatry Physician 2084P0800X RN2390444 MA Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-4063

Mailing address

PO Box 24520
New York, NY 10087-3720

Other practice location 1

595 New Loudon Rd # 279
Latham, NY 12110-4063
Phone (774) 231-1860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814003103 MA Practitioner - Nurse Practitioner 9436599180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, 1,381 clinicians

Practice addresses (Care Compare)

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8771

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-2551

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
093513NYMDClinical Social Worker
RN2390444MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Lahey Clinic, Inc CurrentSince Aug 1, 2025 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Feb 20, 2026 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Organizations & group practices 3

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 2

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": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1124595038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24520",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873720",
            "fax_number": "609-968-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018054063",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "595 New Loudon Rd # 279",
            "address_purpose": "LOCATION",
            "city": "Latham",
            "state": "NY",
            "postal_code": "121104063",
            "country_code": "US",
            "telephone_number": "774-231-1860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "ENRIQUE",
        "credential": "LCSW,LICSW, PMHNP,RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-29",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093513",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "125306",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "RN2390444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.