Individual provider Active NPI

Juan Cruz, CPSS

  • Peer Specialist
  • Omaha, NE
National Provider Identifier
1124631098
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
CPSS-066 Issued in NE
Practice address
11550 I St Ste 100
Omaha, NE 68137-1222
Phone
(402) 616-6060
NPI assigned
Aug 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X CPSS-066 NE Primary

Addresses

Primary practice location

11550 I St Ste 100
Omaha, NE 68137-1222

Mailing address

11550 I St Ste 100
Omaha, NE 68137-1222
Phone (402) 498-4700

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL jmcruz@kvc.org Direct

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

State licenses

LicenseStateTypeSpecialty
CPSS-066NEMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1124631098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11550 I ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371222",
            "telephone_number": "402-498-4700",
            "fax_number": "402-493-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 I ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371222",
            "telephone_number": "402-616-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JUAN",
        "credential": "CPSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NE",
            "license": "CPSS-066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jmcruz@kvc.org",
            "affiliation": "N",
            "endpointDescription": "work e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11550 I St Ste 100",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681371222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.