Deirdre Ingram, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

018963-1 Issued in NY

Practice address

152 West Main Street
Kings Park, NY 11754

Phone

(631) 269-6652

Fax

(631) 269-6654

NPI assigned

Jul 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

May accept Medicare assignment

Group practices

Main Street Physical Therapy and Hand Rehabilitation of Kings Park, PLGroup PAC ID 6709853955, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.06 of 100Reported as individual

Quality

76.11

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Main Street Physical Therapy and Hand Rehabilitation of Kings Park, PL

  • Physical Medicine & Rehabilitation Physician
  • Kings Park, NY
  • NPI 1043385206
  Medicare reassignment Care Compare group NPD
• Home Advantage Physical Therapy PC

  • Physical Therapist
  • Oceanside, NY
  • NPI 1134454119
  Medicare reassignment NPD

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1508066838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 W MAIN STREET",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "11754",
            "telephone_number": "631-269-6652",
            "fax_number": "631-269-6654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 WEST MAIN STREET",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "11754",
            "telephone_number": "631-269-6652",
            "fax_number": "631-269-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "DEIRDRE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-24",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018963-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marian Claire Holmes
• Gabrielle P Hormel, LPN
• Emily Rose Hubert, M.A., CCC-SLP
• David Hynds, PT
• Julianna Iasevoli, REGISTERED NURSE
• International Procurement Solutions Inc
• Ramy Ismail, R.PH.
• Linda Gail Jackson, RN
• Vicki Ann Jacques, RN
• John Gentile DDS PC

• Physical Therapist in Kings Park, NY
• Providers in Kings Park, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.