Active NPI
Nicole Elizabeth Cruz, PA-C
- Medical Physician Assistant
- Plano, TX
National Provider Identifier
1255650107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 5228 W Plano Pkwy
Plano, TX 75093-5005 - Phone
- (972) 250-5700
- Fax
- (972) 250-5748
- NPI assigned
- May 18, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
5228 W Plano Pkwy
Plano, TX 75093-5005
Mailing address
2500 N Houston St
Apt 603
Dallas, TX 75219-7655
Phone (972) 250-5700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TEMPORARY LICENSE | Other | TX | TEXAS STATE LICENSE TEMPORARY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 325-7520
1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689
Hospital & facility affiliations
- St Francis Hospital - the Heart Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- West Islip, NY
- NPI 1124184544
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Roslyn, NY
- NPI 1043279565
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373241600000",
"number": "1255650107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 N HOUSTON ST",
"address_2": "APT 603",
"city": "DALLAS",
"state": "TX",
"postal_code": "752197655",
"telephone_number": "972-250-5700",
"fax_number": "972-250-5748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5228 W PLANO PKWY",
"city": "PLANO",
"state": "TX",
"postal_code": "750935005",
"telephone_number": "972-250-5700",
"fax_number": "972-250-5748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "NICOLE",
"middle_name": "ELIZABETH",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-18",
"last_updated": "2013-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE LICENSE TEMPORARY",
"identifier": "TEMPORARY LICENSE",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.