Individual provider Active NPI

Celina V Ingram, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
National Provider Identifier
1215193701
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
Q78707 Issued in TX
Practice address
3445 Executive Center Dr Ste 250
Austin, TX 78731-1678
Phone
(512) 579-4000
Fax
(512) 222-0146
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Q78707 TX Primary

Addresses

Primary practice location

3445 Executive Center Dr Ste 250
Austin, TX 78731-1678

Mailing address

3445 Executive Center Dr. Ste 250
Austin, TX 78731-1678
Phone (512) 579-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160531000993 TX Practitioner - Pathology 9335456748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Medical School at San Antonio, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3445 Executive Ctr Dr
Suite 250
Austin, TX 78731-1678
Phone (512) 579-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q78707TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hurt, Jacknow, Moore, Connor, Wells, Michels, Yurco, Listrom & Huang Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2023 Accepting new patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

12221 N Mopac Expy
Fl 4
Austin, TX 78758
Phone (512) 901-1215

3445 Executive Center Dr
Ste 250
Austin, TX 78731
Phone (512) 339-1275

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

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 4

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1215193701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 EXECUTIVE CENTER DR. STE 250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311678",
            "telephone_number": "512-579-4000",
            "fax_number": "512-222-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 EXECUTIVE CENTER DR STE 250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311678",
            "telephone_number": "512-579-4000",
            "fax_number": "512-222-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "CELINA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "Q78707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.