Individual provider Active NPI

Jessica Cruz, NP

  • Family Nurse Practitioner
  • Bristol, CT
National Provider Identifier
1679946784
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
006305 Issued in CT
Practice address
61 Bellevue Ave
Bristol, CT 06010-5815
Phone
(860) 589-1682
NPI assigned
Nov 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 006305 CT Primary

Addresses

Primary practice location

61 Bellevue Ave
Bristol, CT 06010-5815

Mailing address

819 Worcester St
Springfield, MA 01151-1045
Phone (413) 543-6820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, RI, MA, NY4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20160108000614 CT Practitioner - Nurse Practitioner 7012219942 Reassigns benefits to 3 organizations
I20201014001663 RI Practitioner - Nurse Practitioner 7012219942 Reassigns benefits to 1 organization
I20210423000795 MA Practitioner - Nurse Practitioner 7012219942 Reassigns benefits to 1 organization
I20211220001500 NY Practitioner - Nurse Practitioner 7012219942

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006305CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Hospitalists of New England, P.C. Family CurrentSince Nov 30, 2015 Accepting new patients
Alignmed Partners, PC CurrentSince Jan 1, 2018 Accepting new patients
Hospital Medicine Associates LLC CurrentSince Jul 1, 2017 Accepting new patients
Ipc Hospitalists of New England PC CurrentSince Nov 30, 2015 Accepting new patients
Inhouse Care LLC PastSince Jul 11, 2018 Accepting new patients

Locations

61 Bellevue Ave
Bristol, CT 06010
Phone (281) 968-8121

23 Fair St
Bristol, CT 06010
Phone (860) 347-6300

850 Mix Ave
Hamden, CT 06514
Phone (203) 281-3500

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

31 Vauxhall St
New London, CT 06320
Phone (203) 789-1650

88 Clark Ln
Waterford, CT 06385
Phone (860) 442-0471

1 Emerson Dr
Windsor, CT 06095
Phone (860) 688-6443

Interoperability endpoints

  • Direct secure messaging: jcruz20008@carelonhealth.direct-ci.com

Organizations & group practices 6

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": "1447200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1679946784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WORCESTER ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011511045",
            "telephone_number": "413-543-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 BELLEVUE AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105815",
            "telephone_number": "860-589-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-11",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "006305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.