Individual provider Active NPI

Ingrid Brinkman

  • Hospitalist Physician
  • New Haven, CT
National Provider Identifier
1497040364
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
54846 Issued in CT
Practice address
20 York St
CB-2041
New Haven, CT 06510-3220
Phone
(203) 688-4748
Fax
(203) 688-4740
NPI assigned
Jun 18, 2011
Last updated
Mar 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10041494 TX
Hospitalist Physician 208M00000X 54846 CT Primary

Addresses

Primary practice location

20 York St
CB-2041
New Haven, CT 06510-3220

Mailing address

20 York St
CB-2041
New Haven, CT 06510-3220
Phone (203) 688-4748

Other identifiers 1

IdentifierTypeStateIssuer
BP10041494OtherTXTEXAS MEDICAL BOARD BASIC PERMIT TO PRACTICE MEDICINE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181102000102 VT Practitioner - Internal MedicinePractitioner - Hospitalist 6901123728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Baylor College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brattleboro Memorial HospitalGroup PAC ID 9335112929, 70 clinicians

Practice addresses (Care Compare)

17 Belmont Ave
Suite 1051
Brattleboro, VT 05301-7214
Phone (802) 251-8611

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10041494TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brattleboro Memorial Hospital Internal Medicine CurrentSince May 18, 2019 Accepting new patients

Locations

17 Belmont Ave
Brattleboro, VT 05301
Phone (802) 257-8360

17 Belmont Ave
#2
Brattleboro, VT 05301
Phone (802) 251-8611

17 Belmont Ave
Ste 1051
Brattleboro, VT 05301

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1497040364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "CB-2041",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4748",
            "fax_number": "203-688-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "CB-2041",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4748",
            "fax_number": "203-688-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKMAN",
        "first_name": "INGRID",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-18",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10041494",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "54846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD BASIC PERMIT TO PRACTICE MEDICINE",
            "identifier": "BP10041494",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.