MR. JEFFREY CRUZ
NPI 1548050602
Student in an Organized Health Care Education/Training Program in Saint Clair Shores, MI

Q: What is Jeffrey Cruz's NPI number?

The NPI number for Jeffrey Cruz is 1548050602. It was assigned to this individual provider in the NPPES registry on May 10, 2025.

Q: What is Jeffrey Cruz's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jeffrey Cruz was last updated on March 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 10, 2025PECOS Enrolled

24911 LITTLE MACK AVE STE C, SAINT CLAIR SHORES, MI 48080(586) 777-2050 Get Directions Write a Review

NPPES record last updated: March 31, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 31, 2026, May 10, 2025 (2 updates tracked since 2025).

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About Mr. Jeffrey Cruz NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JEFFREY CRUZ (NPI 1548050602) is an individual student in an organized health care education/training program in Saint Clair Shores, Michigan and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS and maintains a secondary practice location in Mount Pleasant.

NPPES Registry Identity

NPI1548050602

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMR. JEFFREY CRUZ

Location Address24911 LITTLE MACK AVE STE CSaint Clair Shores, MI 48080-3200

Mailing Address855 S Main St Apt 511Royal Oak, MI 48067-3292 · (310) 408-2321

Phone(586) 777-2050

Sole ProprietorNo

Enumeration DateMay 10, 2025

Last NPPES UpdateMarch 31, 20262 updates tracked since enumeration

NPPES CertifiedMarch 31, 2026

✔ NPI 1548050602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

24911 LITTLE MACK AVE STE C, Saint Clair Shores, MI 48080

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Secondary Practice Location 1

Location 11280 E Campus DrMount Pleasant, MI 48859-3292 · Phone (989) 774-7547

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Jeffrey Cruz is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. VANESSA TAN DO, MBA

Student in an Organized Health Care Education/Training Program