Allan Phillip Ingenito, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

29584 Issued in MN

Practice address

3833 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433-2697

Phone

(763) 427-8320

Fax

(763) 302-4338

NPI assigned

Jun 8, 2006

Last updated

Mar 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Allina Health System

  dba Allina Health Buffalo Specialty Clinic

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Allina Health System

  dba Minnesota Perinatal Physicians Edina

  • Obstetrics & Gynecology Physician
  • Edina, MN
  • NPI 1033365853
  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• Mary T Associates Inc

  • Home Health Agency
  • Coon Rapids, MN
  • NPI 1770643694
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1124068770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 COON RAPIDS BLVD NW",
            "address_2": "SUITE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332697",
            "telephone_number": "763-427-8320",
            "fax_number": "763-302-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3833 COON RAPIDS BLVD NW",
            "address_2": "SUITE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332697",
            "telephone_number": "763-427-8320",
            "fax_number": "763-302-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGENITO",
        "first_name": "ALLAN",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "29584",
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MN",
            "license": "29584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "22676",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "100289C029",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP13588",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162078900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI MEDICAID",
            "identifier": "30709400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "07691IN",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0509674",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "130005768",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "0265011",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Infinite Health Collaborative, PA
• Infinite Health Collaborative, PA
• Megan Ingebretson, RD
• Thomas Steven Ingebrigtsen, PA-C
• Clarissa Ingebritson, RDH
• Kaley Ingenito, PA-C
• Lenah Ingutia, DNP, FNP-BC
• Amanda J Ingvaldsen, CRNA
• Insightful Mental Health & Wellness, PLLC
• Interpath Agency LLC

• Neurology Physician in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Neurology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.