NPIMap

Individual provider Active NPI

Ingrid Margot Hall, M.D.

  • Rheumatology Physician
  • Watertown, NY
National Provider Identifier
1235363490
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
303908 Issued in NY
Practice address
629 Washington St Ste 2
Watertown, NY 13601-4083
Phone
(315) 755-3450
Fax
(315) 755-3451
NPI assigned
May 3, 2009
Last updated
Sep 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 35.098517 OH
Rheumatology Physician 207RR0500X 4301104645 MI
Rheumatology Physician 207RR0500X 303908 NY Primary

Addresses

Primary practice location

629 Washington St Ste 2
Watertown, NY 13601-4083

Mailing address

629 Washington St Ste 2
Watertown, NY 13601-4083
Phone (315) 755-3450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140909001120 MI Practitioner - RheumatologyPractitioner - Internal Medicine 4587825369 Reassigns benefits to 1 organization
I20201029001161 NY Practitioner - RheumatologyPractitioner - Internal Medicine 4587825369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Medical CenterGroup PAC ID 8123914876, 157 clinicians

Practice addresses (Care Compare)

629 Washington St
Watertown, NY 13601-4836
Phone (315) 755-3451

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.098517OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle CurrentSince Aug 25, 2014 Accepting new patients
Ella E M Brown Charitable Circle Internal Medicine CurrentSince Aug 25, 2014 Accepting new patients

Locations

14231 Beadle Lake Rd
Battle Creek, MI 49014
Phone (269) 704-5180

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

Interoperability endpoints

  • Direct secure messaging: ingrid.hall@sfhcny.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1241308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1235363490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 WASHINGTON ST STE 2",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014083",
            "telephone_number": "315-755-3450",
            "fax_number": "315-755-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 WASHINGTON ST STE 2",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014083",
            "telephone_number": "315-755-3450",
            "fax_number": "315-755-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "INGRID",
        "middle_name": "MARGOT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-03",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.098517",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301104645",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "303908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.