Edison Bautista Cruz, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

033665-1 Issued in NY

Practice address

2940 Grand Concourse
Suite 1a
Bronx, NY 10458-2611

Phone

(718) 684-2516

Fax

(718) 684-2518

NPI assigned

Oct 20, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Twenty First Century Urology PLLC

  • Urology Physician
  • Monroe, NY
  • NPI 1629267216
  NPD (past)

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1639454671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2157",
            "address_2": "APT D29",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109497157",
            "telephone_number": "718-644-4529",
            "fax_number": "718-684-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 GRAND CONCOURSE",
            "address_2": "SUITE 1A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104582611",
            "telephone_number": "718-684-2516",
            "fax_number": "718-684-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "EDISON",
        "middle_name": "BAUTISTA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-20",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033665-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "033665-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cleidys Cruz
• Cynthia Cruz
• David Cruz, LMSW
• Daysi D. Cruz, MSED
• Doris E Cruz, LCSW
• Egdaly Cruz
• Elisa Brier Cruz, PH.D.
• Guillermo Ramon Cruz Jr., ORT/L
• Jaileen Cruz
• Janelle Cruz, CCC-SLP

• Physical Therapist in Bronx, NY
• Providers in Bronx, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.