Jeffrey Delacruz
Individual provider Active NPI Family Nurse Practitioner · New Haven, CT
NPI 1699415489 · NPPES record last updated Apr 25, 2022
Key facts
- NPI
- 1699415489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 10507 (CT)
- Practice address
- 428 Columbus Ave
New Haven, CT 06519-1233 - Phone
- (203) 503-3000
- NPI assigned
- Mar 30, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cornell Scott Hill Health Corporation
Practice addresses (Care Compare)
428 Columbus Ave
New Haven, CT 06519-1233
Phone (203) 503-3228
Hospital & facility affiliations
- Yale-New Haven Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220503000327 | CT | Practitioner - Nurse Practitioner | 0941697452 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10507 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornell Scott Hill Health Corporation | Current |
Accepting new patients | |
| Cornell Scott Hill Health Corporation | Past | Accepting new patients |
Locations
428 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3228
410 Campbell Ave
West Haven, CT 06516
Phone (203) 503-3400
Interoperability endpoints
- jdelacruz513938@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 10507 | CT | Yes |
Addresses
Primary practice location
428 Columbus Ave
New Haven, CT 06519-1233
Mailing address
428 Columbus Ave
New Haven, CT 06519-1233
Phone (203) 503-3000
Other providers in New Haven, CT
- Caila Degrandi
- Katelyn M Degrazia
- Ariana Deignan-Kosmides
- Lucian V Del Priore
- Charles Dela Cruz
- Katherine M Delancy
- Eva Marjorie Delappe
- Brooke Nicole Delehoy
- Pamela Delerme
- Ronald Delfini
All providers in New Haven, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.