Individual provider Active NPI

Brent Ingelman

  • Physical Therapist
  • Plymouth, MI
National Provider Identifier
1053836965
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
801 W Ann Arbor TRL Ste 220
Plymouth, MI 48170-6224
Phone
(866) 991-0900
Fax
(866) 992-0900
NPI assigned
Aug 11, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 Primary

Addresses

Primary practice location

801 W Ann Arbor TRL Ste 220
Plymouth, MI 48170-6224

Mailing address

801 W Ann Arbor TRL Ste 220
Plymouth, MI 48170-6224
Phone (866) 991-0900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180102002464 CA Practitioner - Physical Therapist in Private Practice 6305104910 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians
Rehab Specialists IncGroup PAC ID 7810071958, 25 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

2730 Wilshire Blvd
Suite 533
Santa Monica, CA 90403-4751
Phone (310) 273-0877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adi Rehab, Incorporated Physical Therapist CurrentSince Dec 3, 2023 Accepting new patients
Head 2 Toe Physical Therapy, Inc. CurrentSince Oct 2, 2017 Accepting new patients
Rehab Specialists, Inc Physical Therapist CurrentSince Dec 3, 2023 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Mar 3, 2025 Accepting new patients
Sylvia a Mehl Physical Therapy Inc Physical Therapist PastSince Oct 2, 2017 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

210 N Aviation Blvd
Unit B
Manhattan Beach, CA 90266
Phone (310) 251-5920

2730 Wilshire Blvd
Ste 533
Santa Monica, CA 90403
Phone (310) 273-0870

10635 Santa Monica Blvd
Ste 165
West Los Angeles, CA 90025
Phone 3102730877143

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053836965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W ANN ARBOR TRL STE 220",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706224",
            "telephone_number": "866-991-0900",
            "fax_number": "866-992-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W ANN ARBOR TRL STE 220",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706224",
            "telephone_number": "866-991-0900",
            "fax_number": "866-992-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGELMAN",
        "first_name": "BRENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.