Individual provider Active NPI

Brent S. Ingerick, DO

  • Family Medicine Physician
  • Elmira, NY
National Provider Identifier
1669440707
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
232476-1 Issued in NY
Practice address
1336 Cedar St
Elmira, NY 14904-2951
Phone
(607) 734-3929
Fax
(607) 734-0781
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS012494 PA
Family Medicine Physician 207Q00000X 232476-1 NY Primary

Addresses

Primary practice location

1336 Cedar St
Elmira, NY 14904-2951

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Other practice location 1

1243 Pennsylvania Ave
Pine City, NY 14871-9230
Phone (607) 734-3929

Other identifiers 7

IdentifierTypeStateIssuer
1012062540001MedicaidPA
02581455MedicaidNY
GU039851OtherPAMEDICARE GROUP
P00337166OtherPARR MEDICARE PIN
CC8362OtherNYRR MEDICARE GROUP
P00173974OtherNYRR MEDICARE PIN
CC9269OtherPARR MEDICARE GROUP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bingerick7450@direct-guthrie.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 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

Enrollment IDStateProvider typePAC IDDetails
I20040831001485 NY Practitioner - Family Practice 0244205375 Reassigns benefits to 1 organization
I20060824000084 PA Practitioner - Family Practice 0244205375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, shared by 5 NPIs, 795 clinicians

Practice addresses (Care Compare)

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

130 Ctr Way
Corning, NY 14830-2255
Phone (607) 936-9971

1336 Cedar St
Elmira, NY 14904-2951
Phone (607) 734-3929

1780 Hanshaw Rd
Ithaca, NY 14850-9105
Phone (607) 257-5858

31 Arnot Rd
A
Horseheads, NY 14845-8533
Phone (607) 795-5100

One Guthrie SQ
Sayre, PA 18840-1625

One Guthrie Square
Sayre, PA 18840-1625

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Corning, NY, CCN 337292
  • Carefirst / Southern Tier Hospice and Palliative Hospice, Painted Post, NY, CCN 331513
  • Robert Packer Hospital Hospital, Sayre, PA, CCN 390079
  • Corning Hospital Hospital, Corning, NY, CCN 330277
  • Arnot Ogden Medical Center Hospital, Elmira, NY, CCN 330090
  • Troy Community Hospital Hospital, Troy, PA, CCN 391305

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232476-1NYMDFamily Medicine Physician
OS012494PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. Family Medicine CurrentSince Jul 14, 2004 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jul 14, 2004 Accepting new patients
Guthrie Medical Group, P.C. Family Medicine CurrentSince Jul 7, 2006 Accepting new patients
Guthrie Medical Group, P.C. Family Medicine Current Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

1336 Cedar St
Elmira, NY 14904
Phone (607) 734-3929

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1669440707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 CEDAR ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149042951",
            "telephone_number": "607-734-3929",
            "fax_number": "607-734-0781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1243 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Pine City",
            "state": "NY",
            "postal_code": "148719230",
            "country_code": "US",
            "telephone_number": "607-734-3929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGERICK",
        "first_name": "BRENT",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS012494",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "232476-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012062540001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02581455",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "GU039851",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00337166",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CC8362",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00173974",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CC9269",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bingerick7450@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1336 Cedar St",
            "city": "Elmira",
            "state": "NY",
            "country_code": "US",
            "postal_code": "149042951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.