Individual provider Active NPI

Malgorzata Lis-Cruz, PT

  • Physical Therapist
  • Far Rockaway, NY
National Provider Identifier
1821038381
Registry record updated May 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013294 Issued in NY
Practice address
1600 Central Ave 5TH Floor
Far Rockaway, NY 11691
Phone
(718) 337-3390
Fax
(718) 337-3339
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 013294 NY Primary

Addresses

Primary practice location

1600 Central Ave 5TH Floor
Far Rockaway, NY 11691

Mailing address

16 Cornwell St
Rockville Centre, NY 11570-1903
Phone (516) 431-4051

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040518000716 NY Practitioner - Physical Therapist in Private Practice 4486644655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1600 Central Ave
FL 5
Far Rockaway, NY 11691-4018
Phone (718) 337-3390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cruz Physical Therapy, PC CurrentSince May 6, 2013 Accepting new patients
Luis F. Cruz MD PC CurrentSince Jul 10, 2014 Accepting new patients
Northstar Medical PLLC Past Accepting new patients

Locations

1600 Central Ave
Fl 5
Far Rockaway, NY 11691
Phone (718) 337-3390

493 Beach 20th St
Far Rockaway, NY 11691
Phone (718) 265-9900

Organizations & group practices 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683417600000",
    "number": "1821038381",
    "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": "516-431-4051"
        },
        {
            "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": "11691",
            "telephone_number": "718-337-3390",
            "fax_number": "718-337-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIS-CRUZ",
        "first_name": "MALGORZATA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2023-05-07",
        "certification_date": "2023-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013294",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.