Individual provider Active NPI

Nicole Angeline Cruci, NP

  • Family Nurse Practitioner
  • Brewster, NY
National Provider Identifier
1710348263
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F340496-1 Issued in NY
Practice address
111 Clock Tower CMNS
Brewster, NY 10509-4055
Phone
(845) 592-4828
NPI assigned
Mar 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 340496 NY
Family Nurse Practitioner 363LF0000X F340496-1 NY Primary

Addresses

Primary practice location

111 Clock Tower CMNS
Brewster, NY 10509-4055

Mailing address

111 Clock Tower CMNS
Brewster, NY 10509-4055
Phone (845) 592-4828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170719002000 NY Practitioner - Nurse Practitioner 5890065189 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
340496NYMDPsychiatry Physician
F340496-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Services of New York, P.C. CurrentSince Dec 1, 2022 Accepting new patients

Locations

670 Stoneleigh Ave
Carmel, NY 10512
Phone (845) 230-4721

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

6511 Spring Brook Ave
Rhinebeck, NY 12572
Phone (845) 871-3368

Organizations & group practices 1

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": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1710348263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CLOCK TOWER CMNS",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094055",
            "telephone_number": "845-592-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CLOCK TOWER CMNS",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094055",
            "telephone_number": "845-592-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUCI",
        "first_name": "NICOLE",
        "middle_name": "ANGELINE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-11",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "340496",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F340496-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

Verify at the official NPI Registry.