Active NPI
Jimmy Cruz
- Assistant Behavior Analyst
- Bronx, NY
National Provider Identifier
1548926504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- License
- 1554292212
- Practice address
- 961 Rev James a Polite Ave Apt 512
Bronx, NY 10459-3569 - Phone
- (347) 238-4273
- NPI assigned
- Nov 15, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | 1554292212 | NY | |
| Assistant Behavior Analyst | 106E00000X | 1554292212 | NY | Primary |
Addresses
Primary practice location
961 Rev James a Polite Ave Apt 512
Bronx, NY 10459-3569
Mailing address
961 Rev James a Polite Ave Apt 512
Bronx, NY 10459-3569
Phone (347) 238-4273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1554292212 | NY | MD | Early Intervention Provider Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1548926504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "961 REV JAMES A POLITE AVE APT 512",
"city": "BRONX",
"state": "NY",
"postal_code": "104593569",
"telephone_number": "347-238-4273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "961 REV JAMES A POLITE AVE APT 512",
"city": "BRONX",
"state": "NY",
"postal_code": "104593569",
"telephone_number": "347-238-4273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "JIMMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-15",
"last_updated": "2021-11-15",
"certification_date": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": "NY",
"license": "1554292212",
"primary": false
},
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "NY",
"license": "1554292212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.