Nichole M Cruz, OD is a medicare enrolled "Optometrist" provider in Random Lake, Wisconsin. She went to Southern California College Of Optometry and graduated in 2000 and has 24 years of diverse experience with area of expertise as Optometry. Her current practice location is
675 Wolf Rd, Random Lake, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 994-8500.
Nichole M Cruz is licensed to practice in Wisconsin (license number 2823-035) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1801906102.
Healthcare Provider's Profile
| Full Name | Nichole M Cruz |
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| Gender | Female |
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| Speciality | Optometry |
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| Experience | 24 Years |
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| Location | 675 Wolf Rd, Random Lake, Wisconsin |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Nichole M Cruz attended and graduated from Southern California College Of Optometry in 2000
NPI Data:
- NPI Number: 1801906102
- Provider Enumeration Date: 08/30/2006
- Last Update Date: 05/19/2014
Medicare PECOS Information:
- PECOS PAC ID: 1355407594
- Enrollment ID: I20090312000650
Medical Identifiers
Medical identifiers for Nichole M Cruz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1801906102 | NPI | - | NPPES |
| 38623000 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 2823-035 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nichole M Cruz is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Nichole M Cruz, OD
675 Wolf Rd, P.o.box 2,
Random Lake, WI 53075-1264
Ph: (920) 994-8500 | Nichole M Cruz, OD
675 Wolf Rd,
Random Lake, WI 53075-1264
Ph: (920) 994-8500 |
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