NPIMap

Individual provider Active NPI

Marc Ingerman

  • Surgical Physician Assistant
  • Norwalk, CT
National Provider Identifier
1689047995
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3471 Issued in CT
Practice address
34 Maple St
Norwalk, CT 06850
Phone
(203) 852-2188
NPI assigned
Nov 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 3471 CT Primary

Addresses

Primary practice location

34 Maple St
Norwalk, CT 06850

Mailing address

34 Maple St
Norwalk, CT 06850-3815
Phone (203) 852-2188

Other practice location 1

1579 Straits Tpke
Suite 2A
Middlebury, CT 06762-1835
Phone (203) 757-8361 ext. 337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201123002936 NY Practitioner - Physician Assistant 8123326022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Post Road Medical Services PCGroup PAC ID 6406198506, 419 clinicians

Practice addresses (Care Compare)

41 E Post Rd
White Plains, NY 10601-4607
Phone (914) 681-0600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

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 6

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": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1689047995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MAPLE ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503815",
            "telephone_number": "203-852-2188",
            "fax_number": "203-899-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MAPLE ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "06850",
            "telephone_number": "203-852-2188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1579 Straits Tpke",
            "address_2": "Suite 2A",
            "address_purpose": "LOCATION",
            "city": "Middlebury",
            "state": "CT",
            "postal_code": "067621835",
            "country_code": "US",
            "telephone_number": "203-757-8361 x337",
            "fax_number": "203-754-9126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGERMAN",
        "first_name": "MARC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-09",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "3471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.