Active NPI
Mary Soraghan Ingemi
- Physical Therapist
- Wakefield, MA
National Provider Identifier
1609114677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4925
- Practice address
- 10 Richardson Ave
Wakefield, MA 01880-2913 - Phone
- (781) 245-1223
- NPI assigned
- Jan 24, 2013
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4925 | MA | Primary |
Addresses
Primary practice location
10 Richardson Ave
Wakefield, MA 01880-2913
Mailing address
86 Kimball St
Malden, MA 02148-1628
Phone (617) 365-6191
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4925 | MA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358985600000",
"number": "1609114677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86 KIMBALL ST",
"city": "MALDEN",
"state": "MA",
"postal_code": "021481628",
"telephone_number": "617-365-6191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 RICHARDSON AVE",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018802913",
"telephone_number": "781-245-1223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORAGHAN INGEMI",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-24",
"last_updated": "2013-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "4925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wakefield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.