Individual provider Active NPI

Marilou Cruz, APN

  • Adult Health Nurse Practitioner
  • Lakewood, NJ
National Provider Identifier
1235672916
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00676900 Issued in NJ
Practice address
685 River Ave
Suite 3
Lakewood, NJ 08701-5288
Phone
(732) 987-3855
Fax
(732) 282-7200
NPI assigned
Nov 29, 2016
Last updated
Nov 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00676900 NJ Primary

Addresses

Primary practice location

685 River Ave
Suite 3
Lakewood, NJ 08701-5288

Mailing address

685 River Ave
Suite 3
Lakewood, NJ 08701-5288
Phone (732) 987-3855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20170119002766 NJ Practitioner - Nurse Practitioner 1153603576 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00676900NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Botox and Family Associates LLC CurrentSince Dec 4, 2018 Accepting new patients
Great Health Medical New Jersey PC CurrentSince Sep 1, 2024 Accepting new patients
Ocean Family & Geriatric Associates LLC CurrentSince Dec 17, 2017 Accepting new patients
Vitality NP Group LLC Adult Health PastSince Dec 1, 2016 Accepting new patients

Locations

101 Chase Ave
Ste 105
Lakewood, NJ 08701
Phone (212) 201-1252

20 Hospital Dr
Ste 3
Toms River, NJ 08755
Phone (732) 341-9900

407 Willoughby Ave
Brooklyn, NY 11205
Phone (212) 201-1252

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1235672916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 RIVER AVE",
            "address_2": "SUITE 3",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015288",
            "telephone_number": "732-987-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 RIVER AVE",
            "address_2": "SUITE 3",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015288",
            "telephone_number": "732-987-3855",
            "fax_number": "732-282-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "MARILOU",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00676900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.