Individual provider Active NPI

Marinely Cruz-Amy, M.D.

  • Medical Oncology Physician
  • Orange City, FL
National Provider Identifier
1740499532
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
ME111183 Issued in FL
Practice address
765 Image Way
Orange City, FL 32763-8399
Phone
(386) 774-7411
Fax
(386) 774-7412
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X ME111183 FL Primary

Addresses

Primary practice location

765 Image Way
Orange City, FL 32763-8399

Mailing address

PO Box 102222
Attn Credentialing Dept
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
009351400MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120202000468 FL Practitioner - Hematology/OncologyPractitioner - Internal Medicine 9638336639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Brevard Medical Support IncGroup PAC ID 7618870296, 62 clinicians

Practice addresses (Care Compare)

830 Century Medical Dr
Suite B
Titusville, FL 32796-2149
Phone (321) 268-6831

Hospital & facility affiliations

  • Parrish Medical Center Hospital, Titusville, FL, CCN 100028

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
75.26
Promoting interoperability
100
Improvement activities
40
Cost
78.14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Brevard Medical Support, Inc CurrentSince Feb 2, 2024 Accepting new patients

Locations

490 N Washington Ave
Titusville, FL 32796
Phone 32126842003506

250 Harrison St
Titusville, FL 32780
Phone (321) 268-6868

830 Century Medical Dr
Ste B
Titusville, FL 32796
Phone (321) 268-6831

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

Interoperability endpoints

  • Direct secure messaging: marinely.cruz-amy.1@17832.direct.athenahealth.com

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.

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1740499532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "address_2": "ATTN CREDENTIALING DEPT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200",
            "fax_number": "239-278-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 IMAGE WAY",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638399",
            "telephone_number": "386-774-7411",
            "fax_number": "386-774-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ-AMY",
        "first_name": "MARINELY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "ME111183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009351400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.