Active NPI
Ingrid Y Henar, MD
- Pediatric Adolescent Medicine Physician
- Malden, MA
National Provider Identifier
1407820046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 51855
- Practice address
- South Cove Community Center
277 Commercial Street
Malden, MA 02148 - Phone
- (617) 253-1505
- NPI assigned
- Feb 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 51855 | MA | |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 51855 | MA | Primary |
Addresses
Primary practice location
South Cove Community Center
277 Commercial Street
Malden, MA 02148
Mailing address
Ingrid Henar MD/South Cove Community Health Center
277 Commercial Street
Malden, MA 02148
Phone (617) 253-1505
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J08794 | Other | MA | BLUE CROSS |
| 110060594A | Medicaid | MA |
Other names 1
- Ingrid Y Henar
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575417600000",
"number": "1407820046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "INGRID HENAR MD/SOUTH COVE COMMUNITY HEALTH CENTER",
"address_2": "277 COMMERCIAL STREET",
"city": "MALDEN",
"state": "MA",
"postal_code": "02148",
"telephone_number": "617-253-1505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SOUTH COVE COMMUNITY CENTER",
"address_2": "277 COMMERCIAL STREET",
"city": "MALDEN",
"state": "MA",
"postal_code": "02148",
"telephone_number": "617-253-1505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENAR",
"first_name": "INGRID",
"middle_name": "Y",
"name_prefix": "Ms.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-13",
"last_updated": "2019-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "51855",
"primary": false
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "MA",
"license": "51855",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "J08794",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110060594A",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "INGRID",
"last_name": "HENAR",
"middle_name": "Y",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Malden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.