Individual provider Active NPI

Ingolf Tuerk, M.D.

  • Urology Physician
  • Brighton, MA
National Provider Identifier
1013064054
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
216788 Issued in MA
Practice address
11 Nevins St
Ste 303
Brighton, MA 02135-3514
Phone
(617) 787-8181
Fax
(617) 787-4644
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 216788 MA Primary

Addresses

Primary practice location

11 Nevins St
Ste 303
Brighton, MA 02135-3514

Mailing address

11 Nevins St
Suite 303
Brighton, MA 02135-3514
Phone (617) 787-8181

Other identifiers 1

IdentifierTypeStateIssuer
2107481MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1013064054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 NEVINS ST",
            "address_2": "SUITE 303",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353514",
            "telephone_number": "617-787-8181",
            "fax_number": "617-787-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 NEVINS ST",
            "address_2": "STE 303",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353514",
            "telephone_number": "617-787-8181",
            "fax_number": "617-787-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUERK",
        "first_name": "INGOLF",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "216788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2107481",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.