NPIMap

Individual provider Active NPI

Elizabeth Cruz, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Germantown, TN
National Provider Identifier
1437419017
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
56405 Issued in TN
Practice address
7645 Wolf River Cir Ste 100
Germantown, TN 38138-1751
Phone
(901) 405-0275
Fax
(901) 405-0287
NPI assigned
May 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 56405 TN Primary

Addresses

Primary practice location

7645 Wolf River Cir Ste 100
Germantown, TN 38138-1751

Mailing address

7645 Wolf River Cir Ste 100
Germantown, TN 38138-1751
Phone (901) 405-0275

Other practice location 1

4500 Parsons Blvd
Flushing, NY 11355-2205
Phone (718) 670-5535

Other practice location 2

4500 Parsons Blvd
Flushing, NY 11355-2205
Phone (718) 670-5535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160614001873 NY Practitioner - Neurology 4688965155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-2599

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (631) 638-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56405TNMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital at Stony Brook Current Accepting new patients

Locations

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: elizabeth.cruz1@direct.stonybrookmedicine.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1437419017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7645 WOLF RIVER CIR STE 100",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381751",
            "telephone_number": "901-405-0275",
            "fax_number": "901-405-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7645 WOLF RIVER CIR STE 100",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381751",
            "telephone_number": "901-405-0275",
            "fax_number": "901-405-0287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Parsons Blvd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113552205",
            "country_code": "US",
            "telephone_number": "718-670-5535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4500 Parsons Blvd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113552205",
            "country_code": "US",
            "telephone_number": "718-670-5535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TN",
            "license": "56405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.