Organization Active NPI

Ingleton Dermatology P.C.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1689734790
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
183798 Issued in NY
Legal business name
INGLETON DERMATOLOGY P.C.
Practice address
14 E 4TH St
Suite 505
New York, NY 10012-1155
Phone
(212) 673-7100
Fax
(212) 673-6566
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Authorized official

Name
Rosemarie Y Ingleton, M.DNPI 1366414567
Title
President
Phone
(212) 673-7100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 183798 NY Primary

Addresses

Primary practice location

14 E 4TH St
Suite 505
New York, NY 10012-1155

Mailing address

14 E 4TH St
Suite 505
New York, NY 10012-1155
Phone (212) 673-7100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610001830 NY Part B Supplier - Clinic/Group Practice 5698758597 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

14 E 4th St
Rm 505
New York, NY 10012
Phone (212) 673-7100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1689734790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 E 4TH ST",
            "address_2": "SUITE 505",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100121155",
            "telephone_number": "212-673-7100",
            "fax_number": "212-673-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 E 4TH ST",
            "address_2": "SUITE 505",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100121155",
            "telephone_number": "212-673-7100",
            "fax_number": "212-673-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGLETON DERMATOLOGY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "INGLETON",
        "authorized_official_first_name": "ROSEMARIE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-673-7100",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "183798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.