Individual provider Active NPI

Ingrid L Philemond, NURSE PRACTITIONER

  • Gerontology Nurse Practitioner
  • Chestnut Hill, MA
National Provider Identifier
1245913417
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG07230189 Issued in MA
Practice address
300 South St
Chestnut Hill, MA 02467-3658
Phone
(774) 444-4586
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG07230189 MA Primary

Addresses

Primary practice location

300 South St
Chestnut Hill, MA 02467-3658

Mailing address

135 Short St
Brockton, MA 02302-2662
Phone (774) 444-4586

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251003000729 MA Practitioner - Nurse Practitioner 8325544745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Rehab Consultants LLCGroup PAC ID 7810184892, 162 clinicians

Practice addresses (Care Compare)

500 Wilbur Ave
Somerset, MA 02725-2051
Phone (312) 635-0973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AG07230189MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehab Consultants LLC CurrentSince Aug 1, 2025 Accepting new patients
Integrated Rehab Consultants LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

204 Proctor Ave
Revere, MA 02151
Phone (781) 286-3100

500 Wilbur Ave
Somerset, MA 02725
Phone (508) 675-7589

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.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1245913417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SHORT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022662",
            "telephone_number": "774-444-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SOUTH ST",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673658",
            "telephone_number": "774-444-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILEMOND",
        "first_name": "INGRID",
        "middle_name": "L",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "AG07230189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

Verify at the official NPI Registry.