Individual provider Active NPI

Jacinta Fayo Cruz, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1588908628
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN001459 Issued in NV
Practice address
5536 S Fort Apache Rd Ste 102
Las Vegas, NV 89148-7687
Phone
(702) 915-7001
Fax
(702) 909-9254
NPI assigned
Nov 15, 2012
Last updated
Jul 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X TAPN700839 NV
Family Nurse Practitioner 363LF0000X APRN001459 NV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN001459 NV Primary

Addresses

Primary practice location

5536 S Fort Apache Rd Ste 102
Las Vegas, NV 89148-7687

Mailing address

11035 Lavender Hill Dr Ste 160-441
Las Vegas, NV 89135-2955

Other identifiers 1

IdentifierTypeStateIssuer
1588908628MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130402000398 NV Practitioner - Nurse Practitioner 6406091073 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bauza Neuropsychiatry Center LLCGroup PAC ID 7618370040, 6 clinicians
Behavioral Health Institute Inc (Singh) PCGroup PAC ID 0042398984, 13 clinicians
Uzma Zafar MD PCGroup PAC ID 3476605536, 4 clinicians

Practice addresses (Care Compare)

1601 E Flamingo Rd
Suite 18
Las Vegas, NV 89119-5244
Phone (702) 478-9971

3247 S Maryland Pkwy
Las Vegas, NV 89109-2412
Phone (702) 852-6633

5536 S Fort Apache Rd
Suite 102
Las Vegas, NV 89148-7687
Phone (725) 666-1636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TAPN700839NVMDFamily Nurse Practitioner
APRN001459NVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Uzma Zafar MD PC Psychiatry CurrentSince Jul 1, 2020 Accepting new patients
Bauza Neuropsychiatry Center LLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

11035 Lavender Hill Dr
Ste 160441
Las Vegas, NV 89135

1601 E Flamingo Rd
Ste 18
Las Vegas, NV 89119
Phone (702) 478-9971

5536 S Fort Apache Rd
Ste 102
Las Vegas, NV 89148
Phone (702) 456-8299

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1588908628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11035 LAVENDER HILL DR STE 160-441",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891352955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5536 S FORT APACHE RD STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487687",
            "telephone_number": "702-915-7001",
            "fax_number": "702-909-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JACINTA",
        "middle_name": "FAYO",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "TAPN700839",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN001459",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "APRN001459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588908628",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.