Individual provider Active NPI

Ovidiu Cruceru

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1669105672
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11019381 Issued in FL
Practice address
4844 Deer Lake Dr W Ste 101
Jacksonville, FL 32246-4406
Phone
(904) 376-3800
Fax
(904) 390-7431
NPI assigned
Jul 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11019381 FL Primary

Addresses

Primary practice location

4844 Deer Lake Dr W Ste 101
Jacksonville, FL 32246-4406

Mailing address

PO Box 748519
Atlanta, GA 30374-8519
Phone (904) 376-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20221012004128 FL Practitioner - Nurse Practitioner 5799151908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Behavioral Health LLCGroup PAC ID 7315166394, 120 clinicians

Practice addresses (Care Compare)

4844 Deer Lake Dr W
Suite 101
Jacksonville, FL 32246-4406
Phone (904) 376-3800

Merit-based Incentive Payment System (MIPS)

Final score
89.95 of 100Reported as group
Quality
84.69
Promoting interoperability
100
Improvement activities
40
Cost
74.91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Behavioral Health, LLC CurrentSince Oct 31, 2022 Accepting new patients
Southern Baptist Hospital of Florida Inc Past Accepting new patients

Locations

820 Prudential Dr
Ste 510
Jacksonville, FL 32207

4844 Deer Lake Dr W
Ste 101
Jacksonville, FL 32246

3650 NW Devane St
Lake City, FL 32055
Phone (386) 755-1221

87010 Professional Way
Yulee, FL 32097

Interoperability endpoints

  • Direct secure messaging: ocruceru124440@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1669105672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4844 DEER LAKE DR W STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464406",
            "telephone_number": "904-376-3800",
            "fax_number": "904-390-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUCERU",
        "first_name": "OVIDIU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-07",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11019381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.