Individual provider Active NPI

Michelle Ayun Ayun Cruz, PT

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1265752893
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2307001471 Issued in VA
Practice address
928 Diamond Springs Rd Ste 103
Virginia Beach, VA 23455-6601
Phone
(577) 395-1975
Fax
(757) 425-7180
NPI assigned
Jun 5, 2010
Last updated
Dec 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 23191 MD
Physical Therapist 225100000X 2307001471 VA Primary

Addresses

Primary practice location

928 Diamond Springs Rd Ste 103
Virginia Beach, VA 23455-6601

Mailing address

928 Diamond Springs Rd Ste 103
Virginia Beach, VA 23455-6601
Phone (577) 395-1975

Other practice location 1

5660 Indian River Rd Ste 121
Virginia Beach, VA 23464-5240
Phone (757) 252-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201214002603 VA Practitioner - Physical Therapist in Private Practice 0345432316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2307001471VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holding LLC Physical Therapist Past Accepting new patients
Accessible Physical Therapy Services, LLC Physical Therapist PastSince Nov 24, 2019 Accepting new patients
Sentara Hospitals Past Accepting new patients

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": "1275696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1265752893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 DIAMOND SPRINGS RD STE 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556601",
            "telephone_number": "577-395-1975",
            "fax_number": "757-425-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 DIAMOND SPRINGS RD STE 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556601",
            "telephone_number": "577-395-1975",
            "fax_number": "757-425-7180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5660 Indian River Rd Ste 121",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234645240",
            "country_code": "US",
            "telephone_number": "757-252-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "MICHELLE",
        "middle_name": "AYUN AYUN",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-05",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23191",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2307001471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.