NPIMap

Organization Active NPI

Neuroshield Network SE LLC

Doing business as Neuroshield Network, LLC

  • Clinical Neurophysiology Physician
  • Fairfield, NJ
National Provider Identifier
1538600606
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
Legal business name
NEUROSHIELD NETWORK SE LLC
Doing business as
Neuroshield Network, LLC
Practice address
700 US Highway 46
Suite 420
Fairfield, NJ 07004-1591
Phone
(973) 882-3456
Fax
(973) 882-3450
NPI assigned
Mar 9, 2017
Last updated
Mar 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Marcos J Cruz, M.D.NPI 1265556898
Title
Owner
Phone
(973) 882-3456

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X NU Primary

Addresses

Primary practice location

700 US Highway 46
Suite 420
Fairfield, NJ 07004-1591

Mailing address

PO Box 75103
Chicago, IL 60675-5103
Phone (973) 882-3456

Other names 1

  • Neuroshield Network, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC, SC, FL, VA, SD6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20171113003482 GA Part B Supplier - Clinic/Group Practice 7719243492 Receives reassigned benefits from 12 practitioners
Practice locations: Atlanta, GA
O20180924000881 NC Part B Supplier - Clinic/Group Practice 7719243492 Receives reassigned benefits from 10 practitioners
Practice locations: Raleigh, NC
O20180924001475 SC Part B Supplier - Clinic/Group Practice 7719243492 Receives reassigned benefits from 10 practitioners
Practice locations: West Columbia, SC
O20190125003068 FL Part B Supplier - Clinic/Group Practice 7719243492 Receives reassigned benefits from 10 practitioners
Practice locations: Jacksonville, FL; Tampa, FL; St Petersburg, FL; Largo, FL
O20190319002280 VA Part B Supplier - Clinic/Group Practice 7719243492 Receives reassigned benefits from 9 practitioners
Practice locations: Danville, VA
O20210204000334 SD Part B Supplier - Clinic/Group Practice 7719243492 Receives reassigned benefits from 7 practitioners
Practice locations: Rapid City, SD

National Provider Directory

National Provider Directory

Locations

400 W Peachtree St NW
Ste 400
Atlanta, GA 30308

1880 Beaver Ridge Cir
Norcross, GA 30071
Phone (404) 422-4947

3201 Edwards Mill Rd
Ste 141485
Raleigh, NC 27612

215 Anamaria Dr
Rapid City, SD 57701
Phone (605) 721-4700

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1538600606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606755103",
            "telephone_number": "973-882-3456",
            "fax_number": "973-882-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 US HIGHWAY 46",
            "address_2": "SUITE 420",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070041591",
            "telephone_number": "973-882-3456",
            "fax_number": "973-882-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSHIELD NETWORK SE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-09",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "MARCOS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-882-3456",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neuroshield Network, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.