Individual provider Active NPI

Yoanny R. Cruz

  • Personal Care Attendant
  • Las Vegas, NV
National Provider Identifier
1144728650
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
2101075507 Issued in NV
Practice address
1951 Stella Lake St
Las Vegas, NV 89106-2114
Phone
(702) 888-1415
NPI assigned
Jan 30, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X 2101075507 NV Primary

Addresses

Primary practice location

1951 Stella Lake St
Las Vegas, NV 89106-2114

Mailing address

1951 Stella Lake St
Las Vegas, NV 89106-2114
Phone (702) 888-1415

Other identifiers 1

IdentifierTypeStateIssuer
2101075507MedicaidNV

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
2101075507NVMDPersonal Care Attendant

NPI Registry JSON

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

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517270400000",
    "number": "1144728650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 STELLA LAKE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062114",
            "telephone_number": "702-888-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 STELLA LAKE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062114",
            "telephone_number": "702-888-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "YOANNY",
        "middle_name": "R.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-30",
        "last_updated": "2018-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NV",
            "license": "2101075507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2101075507",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; 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.