Individual provider Active NPI

Marcelo Cruz Laiz, M.D.

  • Internal Medicine Physician
  • New Rochelle, NY
National Provider Identifier
1558406967
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
183891 Issued in NY
Practice address
140 Lockwood Avenue
Suite 203
New Rochelle, NY 10801-4908
Phone
(914) 636-6330
Fax
(914) 636-1407
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 183891 NY Primary

Addresses

Primary practice location

140 Lockwood Avenue
Suite 203
New Rochelle, NY 10801-4908

Mailing address

140 Lockwood Avenue
Suite 203
New Rochelle, NY 10801-4908
Phone (914) 636-6330

Other identifiers 1

IdentifierTypeStateIssuer
01274579MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120530000547 NY Practitioner - Internal Medicine 1951564053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
183891NYMDInternal Medicine Physician

Networks

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

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1558406967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 LOCKWOOD AVENUE",
            "address_2": "SUITE 203",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014908",
            "telephone_number": "914-636-6330",
            "fax_number": "914-636-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LOCKWOOD AVENUE",
            "address_2": "SUITE 203",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014908",
            "telephone_number": "914-636-6330",
            "fax_number": "914-636-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIZ",
        "first_name": "MARCELO",
        "middle_name": "CRUZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "183891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01274579",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

Verify at the official NPI Registry.