Crystal Ingram, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

U5426 Issued in TX

Practice address

1345 6TH Ave
New York, NY 10105-0302

Phone

(855) 624-8963

NPI assigned

Mar 28, 2017

Last updated

Oct 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Crystal Marelli Former name

Medicare fee-for-service enrollment

Enrolled in GU, TX2 enrollments

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 2

Specialty

Family Practice

Education

Arizona College of Osteopathic Medicine Mid Western University, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.33 of 100Reported as group

Quality

82.1

Promoting interoperability

100

Improvement activities

40

Cost

72.34

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Primary Health Physicians, PLLC

  • Urgent Care Clinic/Center
  • Denton, TX
  • NPI 1770048704
  Medicare reassignment Care Compare group NPD
• Takecare Insurance Company Inc.

  dba FHP Health Center

  • Health Service Clinic/Center
  • Tamuning, GU
  • NPI 1972565240

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1588196836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 N CENTRAL EXPY",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750703303",
            "telephone_number": "972-529-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 6TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101050302",
            "telephone_number": "855-624-8963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "CRYSTAL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "320101",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U5426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "MARELLI",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ingleton Dermatology P.C.
• Rosemarie Yvonne Ingleton, MD
• Allan Evans Inglis Jr., M.D.
• Angela R Ingram, MD
• Christopher Macdonald Ingram, MD
• Crystal Ingram
• Deangelo Jamal Ingram, DMD
• Donna A. Ingram, M.D.
• Douglas Howard Ingram, M.D.
• Elise Marie Ingram, PA-C

• Family Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.
• 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.