Individual provider Active NPI

Craig Andrew Ingermann, PA-C

  • Physician Assistant
  • Pensacola, FL
National Provider Identifier
1669498820
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106583 Issued in FL
Practice address
5147 N 9TH Ave Ste 318
Pensacola, FL 32504-8710
Phone
(850) 462-2250
Fax
(850) 741-3053
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9106583 FL Primary

Addresses

Primary practice location

5147 N 9TH Ave Ste 318
Pensacola, FL 32504-8710

Mailing address

1824 King St Ste 200
Jacksonville, FL 32204-4736
Phone (904) 384-3343

Other identifiers 1

IdentifierTypeStateIssuer
1513206MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20120816000518 FL Practitioner - Physician Assistant 1456314400 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

4501 N Davis Hwy
Suite a
Pensacola, FL 32504-2724
Phone (850) 476-9000

5151 N 9TH Ave
Suite 200
Pensacola, FL 32504-8721
Phone (850) 416-4188

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1556TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Sacred Heart Health System Inc CurrentSince Jan 1, 2018 Accepting new patients

Locations

5151 N 9th Ave
Ste 200
Pensacola, FL 32504
Phone (850) 416-4188

4451 Bayou Blvd
Pensacola, FL 32503
Phone (850) 416-7619

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

5147 N 9th Ave
Ste 318
Pensacola, FL 32504
Phone (850) 416-2965

Interoperability endpoints

  • Direct secure messaging: craig.ingermann@hca5.eclinicaldirectplus.com
  • Direct secure messaging: craig.ingermann.2@9582.direct.athenahealth.com

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 1

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1669498820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 KING ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044736",
            "telephone_number": "904-384-3343",
            "fax_number": "904-400-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5147 N 9TH AVE STE 318",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048710",
            "telephone_number": "850-462-2250",
            "fax_number": "850-741-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGERMANN",
        "first_name": "CRAIG",
        "middle_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513206",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.