Individual provider Active NPI

Joshua Cruz, PSYD

  • Psychologist
  • Waterbury, CT
National Provider Identifier
1922409465
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4739 Issued in CT
Practice address
51 N Elm St
Waterbury, CT 06702-1545
Phone
(203) 574-4000
NPI assigned
Sep 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X 4739 CT Primary

Addresses

Primary practice location

51 N Elm St
Waterbury, CT 06702-1545

Mailing address

141 E Main St
4TH Floor Administration
Waterbury, CT 06702-2310
Phone (203) 574-9000

Other practice location 1

141 E Main St
3rd Floor II IICAPS
Waterbury, CT 06702-2310
Phone (203) 574-9000

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240412001747 CT Practitioner - Clinical Psychologist 1951740752 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4739CTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Apr 4, 2024 Accepting new patients
Community Health Center Inc CurrentSince Apr 4, 2024 Accepting new patients
Wellmore, Inc. Past Accepting new patients

Locations

51 N Elm St
Waterbury, CT 06702
Phone (203) 574-4000

Interoperability endpoints

  • Direct secure messaging: joshua.cruz@chcict.eclinicaldirectplus.com

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": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1922409465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "address_2": "4TH FLOOR ADMINISTRATION",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N ELM ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021545",
            "telephone_number": "203-574-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 E Main St",
            "address_2": "3rd Floor II IICAPS",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067022310",
            "country_code": "US",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JOSHUA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-15",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "4739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.