Individual provider Active NPI

Irving Ingraham, MD

  • Gastroenterology Physician
  • Peabody, MA
National Provider Identifier
1073569760
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
45686 Issued in MA
Practice address
2 Essex Center Drive
Peabody, MA 01960
Phone
(978) 532-6111
Fax
(978) 532-6123
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 45686 MA Primary

Addresses

Primary practice location

2 Essex Center Drive
Peabody, MA 01960

Mailing address

PO Box 930
Salem, MA 01970
Phone (978) 825-6581

Other identifiers 1

IdentifierTypeStateIssuer
3105199MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041220000338 MA Practitioner - GastroenterologyPractitioner - Internal Medicine 6305803545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Tufts University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

2 Corporation Way
Suite 180
Peabody, MA 01960-7996
Phone (978) 532-6111

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-2551

Salem Hospital Medical Staff Office
81 Highland Ave Wheelock 6
Salem, MA 01970-2714

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45686MAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Apr 1, 2008 Accepting new patients
North Shore Medical Center, Inc. Past Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

2 Blackburn Park
Gloucester, MA 01930
Phone (508) 281-1500

2 Essex Dr
Peabody, MA 01960
Phone (978) 532-6111

2 Corporation Way
Ste 180
Peabody, MA 01960
Phone (781) 248-1766

2 Essex Center Dr
Ste 2
Peabody, MA 01960
Phone (978) 532-6111

Interoperability endpoints

  • Direct secure messaging: ingraham.irving.nsmc@direct.partners.masshiway.net

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073569760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 930",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "978-825-6581",
            "fax_number": "978-825-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ESSEX CENTER DRIVE",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "978-532-6111",
            "fax_number": "978-532-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAHAM",
        "first_name": "IRVING",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "45686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3105199",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.