Individual provider Active NPI

Cory J Ingram, MD

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Rochester, MN
National Provider Identifier
1104887504
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
48471 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
Fax
(507) 422-0985
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 016883 ME
Geriatric Medicine (Family Medicine) Physician 207QG0300X 48471 MN
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 48471 MN
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 68665 WI
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 48471 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

1695 Lor Ray Drive
ISJ-Mayo Northridge
North Mankato, MN 56003
Phone (507) 387-8231

Other practice location 2

1695 Lor Ray Drive
ISJ-Mayo Northridge
North Mankato, MN 56003
Phone (507) 387-8231

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cingram53193@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20060801000216 MN Practitioner - Hospice/Palliative CarePractitioner - Family PracticePractitioner - Geriatric Medicine 2062427370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Hospital & facility affiliations

  • Mayo Clinic Hospice Hospice, Rochester, MN, CCN 241519
  • Mayo Clinic Hospital Rochester Hospital, Rochester, MN, CCN 240010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48471MNMDGeriatric Medicine (Family Medicine) Physician
68665WIMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jun 1, 2018 Accepting new patients
Mayo Clinic CurrentSince Apr 17, 2014 Accepting new patients
Mayo Clinic Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jun 1, 2018 Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

Interoperability endpoints

  • Direct secure messaging: cingram53193@ehrdirect.mayoclinicmsg.org

Organizations & group practices 4

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1104887504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511",
            "fax_number": "507-422-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511",
            "fax_number": "507-422-0985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1695 Lor Ray Drive",
            "address_2": "ISJ-Mayo Northridge",
            "address_purpose": "LOCATION",
            "city": "North Mankato",
            "state": "MN",
            "postal_code": "56003",
            "country_code": "US",
            "telephone_number": "507-387-8231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1695 Lor Ray Drive",
            "address_2": "ISJ-Mayo Northridge",
            "address_purpose": "LOCATION",
            "city": "North Mankato",
            "state": "MN",
            "postal_code": "56003",
            "country_code": "US",
            "telephone_number": "507-387-8231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "CORY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "016883",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MN",
            "license": "48471",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MN",
            "license": "48471",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "WI",
            "license": "68665",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "MN",
            "license": "48471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cingram53193@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.