Individual provider Active NPI

Jordan Ingalsbe

  • Physical Therapist
  • Maitland, FL
National Provider Identifier
1386310175
Registry record updated Feb 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT37597 Issued in FL
Practice address
405 Lake Howell Rd Ste 1031
Maitland, FL 32751-5926
Phone
(407) 720-4236
NPI assigned
Aug 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT37597 FL Primary

Addresses

Primary practice location

405 Lake Howell Rd Ste 1031
Maitland, FL 32751-5926

Mailing address

1073 Whistling Winds PT
Oviedo, FL 32765-7769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211209001646 FL Practitioner - Physical Therapist in Private Practice 9830589696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tript LLCGroup PAC ID 5395792832, 7 clinicians

Practice addresses (Care Compare)

405 Lake Howell Rd
Suite 1031
Maitland, FL 32751-5926
Phone (407) 671-0433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tript, LLC Physical Therapist CurrentSince Dec 6, 2021 Accepting new patients
Frye Sports Medicine LLC PastSince Aug 1, 2021 Accepting new patients

Locations

405 Lake Howell Rd
Ste 1031
Maitland, FL 32751
Phone (407) 671-0433

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": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644624000000",
    "number": "1386310175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1073 WHISTLING WINDS PT",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327657769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LAKE HOWELL RD STE 1031",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515926",
            "telephone_number": "407-720-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGALSBE",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT37597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.