Individual provider Active NPI

Wilfredo Tomas Correa Cruz, MD

  • Family Medicine Physician
  • Jersey City, NJ
National Provider Identifier
1730116211
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA07690500 Issued in NJ
Practice address
201 Saint Pauls Ave Apt 1D
Jersey City, NJ 07306-3708
Phone
(201) 656-7400
Fax
(201) 653-7960
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA07690500 NJ Primary

Addresses

Primary practice location

201 Saint Pauls Ave Apt 1D
Jersey City, NJ 07306-3708

Mailing address

328 Ridge St
Newark, NJ 07104-1311
Phone (973) 866-9612

Other identifiers 1

IdentifierTypeStateIssuer
0026212MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050302000555 NJ Practitioner - Family Practice 6608843396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

550 Newark Ave
Suite 402
Jersey City, NJ 07306-1326
Phone (201) 918-6732

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07690500NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC CurrentSince Jan 1, 2021 Accepting new patients
Hudson Hospital Opco LLC Current Accepting new patients
James Park Healthcare Inc Past Accepting new patients
Alliance Community Healthcare, Inc. Past Accepting new patients

Locations

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

525 Monmouth St
Jersey City, NJ 07302
Phone (201) 653-8800

550 Newark Ave
Ste 402
Jersey City, NJ 07306
Phone (201) 356-9285

2 Journal Square Plz
Ste 2
Jersey City, NJ 07306
Phone (201) 963-7000

Interoperability endpoints

  • Direct secure messaging: wilfredotomas.cruz@direct.christhospital.md

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1730116211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 RIDGE ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071041311",
            "telephone_number": "973-866-9612",
            "fax_number": "201-653-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SAINT PAULS AVE APT 1D",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063708",
            "telephone_number": "201-656-7400",
            "fax_number": "201-653-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "WILFREDO TOMAS",
        "middle_name": "CORREA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA07690500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0026212",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.