Active NPI
Ingrid Cruse, M.D.
- Pediatrics Physician
- Leominster, MA
National Provider Identifier
1508854878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 78937
- Practice address
- 100 Hospital Rd
Suite 4
Leominster, MA 01453-2253 - Phone
- (978) 514-6300
- Fax
- (978) 514-6324
- NPI assigned
- Oct 11, 2005
- Last updated
- Jun 24, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 78937 | MA | Primary |
Addresses
Primary practice location
100 Hospital Rd
Suite 4
Leominster, MA 01453-2253
Mailing address
100 Hospital Rd
Suite 4
Leominster, MA 01453-2253
Phone (978) 514-6300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3129365 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78937 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Associates Pediatrics, P.C. | Current | Accepting new patients |
Locations
100 Hospital Rd
Ste 4
Leominster, MA 01453
Phone (978) 514-6300
Interoperability endpoints
- icruse14786@direct.chppoc.masshiway.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatric Adolescent Medicine Physician
- Leominster, MA
- NPI 1417946161
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308873600000",
"number": "1508854878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HOSPITAL RD",
"address_2": "SUITE 4",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014532253",
"telephone_number": "978-514-6300",
"fax_number": "978-514-6324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HOSPITAL RD",
"address_2": "SUITE 4",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014532253",
"telephone_number": "978-514-6300",
"fax_number": "978-514-6324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUSE",
"first_name": "INGRID",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-11",
"last_updated": "2011-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "78937",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3129365",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leominster, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.