Individual provider Active NPI

Christopher M Cruz, APRN

  • Family Nurse Practitioner
  • Newington, CT
National Provider Identifier
1780159467
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12.007886 Issued in CT
Practice address
555 Willard Ave
Newington, CT 06111-2631
Phone
(203) 932-5711
NPI assigned
Oct 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12.007886 CT Primary

Addresses

Primary practice location

555 Willard Ave
Newington, CT 06111-2631

Mailing address

950 Campbell Ave
West Haven, CT 06516-2770
Phone (203) 932-5711

Other practice location 1

950 Campbell Ave
West Haven, CT 06516-2770
Phone (203) 932-5711 ext. 12220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20230324000257 CT Order and Referring Only - Nurse Practitioner 8729321096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12.007886CTMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1780159467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162770",
            "telephone_number": "203-932-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 WILLARD AVE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112631",
            "telephone_number": "203-932-5711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 Campbell Ave",
            "address_purpose": "LOCATION",
            "city": "West Haven",
            "state": "CT",
            "postal_code": "065162770",
            "country_code": "US",
            "telephone_number": "203-932-5711 x12220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-09",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.007886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

Sources for this page

Verify at the official NPI Registry.