Active NPI
Michael Thomas Ingram Jr., M.S., M.D.
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1427438415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A145363
- Practice address
- 8271 Melrose Ave Ste 110
Los Angeles, CA 90046-6800 - Phone
- (213) 545-1901
- Fax
- (475) 313-1260
- NPI assigned
- Jun 4, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A145363 | CA | Primary |
Addresses
Primary practice location
8271 Melrose Ave Ste 110
Los Angeles, CA 90046-6800
Mailing address
8271 Melrose Ave Ste 110
Los Angeles, CA 90046-6800
Phone (949) 436-9099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 12, 2024 through Nov 12, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A145363 | CA | MD | Psychiatry Physician |
Interoperability endpoints
- mingram101391@direct.llu.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631750400000",
"number": "1427438415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8271 MELROSE AVE STE 110",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900466800",
"telephone_number": "949-436-9099",
"fax_number": "475-313-1260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8271 MELROSE AVE STE 110",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900466800",
"telephone_number": "213-545-1901",
"fax_number": "475-313-1260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "MICHAEL",
"middle_name": "THOMAS",
"name_suffix": "Jr.",
"credential": "M.S., M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-04",
"last_updated": "2021-09-16",
"certification_date": "2021-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A145363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.