Active NPI
Ingrid Abols-Mantyh, M.D.
- Neurology Physician
- Burnsville, MN
National Provider Identifier
1487607495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 29023
- Practice address
- 675 E Nicollet Blvd
Suite 100
Burnsville, MN 55337-6749 - Phone
- (952) 435-8516
- Fax
- (763) 302-4336
- NPI assigned
- May 19, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 29023 | MN | Primary |
Addresses
Primary practice location
675 E Nicollet Blvd
Suite 100
Burnsville, MN 55337-6749
Mailing address
501 E Nicollet Blvd
Ste 100
Burnsville, MN 55337-6772
Phone (952) 435-8516
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100274C029 | Other | MN | UCARE |
| 31534800 | Medicaid | WI | |
| HP12761 | Other | MN | HEALTHPARTNERS |
| 130004283 | Other | MN | RAILROAD MEDICARE |
| 19364AB | Other | MN | BCBS OF MN |
| 22665 | Other | MN | AMERICA'S PPO |
| 9040978000 | Medicaid | MN | |
| 0265035 | Other | MN | PREFERRED ONE |
| 0517222 | Other | MN | MEDICA |
Other names 1
- Ingrid Abols
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29023 | MN | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551657600000",
"number": "1487607495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 E NICOLLET BLVD",
"address_2": "STE 100",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553376772",
"telephone_number": "952-435-8516",
"fax_number": "763-302-4336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 E NICOLLET BLVD",
"address_2": "SUITE 100",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553376749",
"telephone_number": "952-435-8516",
"fax_number": "763-302-4336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABOLS-MANTYH",
"first_name": "INGRID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-19",
"last_updated": "2019-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MN",
"license": "29023",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "100274C029",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31534800",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP12761",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "130004283",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MN",
"identifier": "19364AB",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO",
"identifier": "22665",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9040978000",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "0265035",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0517222",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "INGRID",
"last_name": "ABOLS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.