Organization Active NPI

Cruz Physical Therapy, PC

  • Physical Therapy Clinic/Center
  • Far Rockaway, NY
National Provider Identifier
1770927063
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
013294 Issued in NY
Legal business name
CRUZ PHYSICAL THERAPY, PC
Practice address
1600 Central Ave 5TH Floor
Far Rockaway, NY 11691-3621
Phone
(718) 337-3390
Fax
(718) 337-3339
NPI assigned
Apr 17, 2013
Last updated
May 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Authorized official

Name
Malgorzata Lis-CruzNPI 1821038381
Title
Owner
Phone
(718) 337-3390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 013294 NY Primary

Addresses

Primary practice location

1600 Central Ave 5TH Floor
Far Rockaway, NY 11691-3621

Mailing address

16 Cornwell St
Rockville Centre, NY 11570-1903
Phone (917) 826-9930

Other identifiers 1

IdentifierTypeStateIssuer
02272719MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130531000228 NY Part B Supplier - Clinic/Group Practice 0446498539 Receives reassigned benefits from 1 practitioner
Practice locations: Far Rockaway, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1770927063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CORNWELL ST",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701903",
            "telephone_number": "917-826-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CENTRAL AVE 5TH FLOOR",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913621",
            "telephone_number": "718-337-3390",
            "fax_number": "718-337-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRUZ PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-17",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "LIS-CRUZ",
        "authorized_official_first_name": "MALGORZATA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-337-3390"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "013294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02272719",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.