Benjamin Ingram

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA064441 Issued in PA

Practice address

120 Fifth Ave Place
Mail Code Hm171-a
Pittsburgh, PA 15222

Phone

(414) 955-6920

NPI assigned

Jul 21, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Endorsed LLC

  • Multi-Specialty Clinic/Center
  • Pittsburgh, PA
  • NPI 1114647054
  NPD

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1578086468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 FIFTH AVE PLACE",
            "address_2": "MAIL CODE HM171-A",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 FIFTH AVE PLACE",
            "address_2": "MAIL CODE HM171-A",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15222",
            "telephone_number": "414-955-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-21",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA064441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF PENNSYLVANIA",
            "identifier": "MA064441",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Infull Psychiatry LLC
• Jordyn Michelle Ingelido
• Micah Ingle, LAPC
• Kenneth Ingold
• Ingram Community Emergency Ambulance Service, Inc
• Michael Ingram
• Sarah Ingram
• Sarah Jean Ingram, LCSW
• Ingrid Fulton-Edwards, LCSW
• Caitlan Ingros, MSW

• Medical Physician Assistant in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.