Individual provider Active NPI

Kristyn B. Ingram, MD

  • Pediatric Anesthesiology Physician
  • Oklahoma City, OK
National Provider Identifier
1770765901
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
N8667 Issued in TX
Practice address
920 Stanton L Young Blvd # Wp1140
Oklahoma City, OK 73104-5036
Phone
(405) 271-4351
NPI assigned
Nov 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 43042 OK
Anesthesiology Physician 207L00000X N8667 TX
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Anesthesiology Physician 207LP3000X N8667 TX Primary

Addresses

Primary practice location

920 Stanton L Young Blvd # Wp1140
Oklahoma City, OK 73104-5036

Mailing address

PO Box 26901
Oklahoma City, OK 73126-0901
Phone (405) 271-4351

Other identifiers 3

IdentifierTypeStateIssuer
302497802MedicaidTX
302497801MedicaidTX
60826576MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 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
I20120705000318 TX Practitioner - AnesthesiologyPractitioner - Other (Physician) 4284899873 Reassigns benefits to 3 organizations
I20240718000547 OK Practitioner - Anesthesiology 4284899873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Medical School at San Antonio, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guide Anesthesia TX PLLCGroup PAC ID 5294170379, 35 clinicians

Practice addresses (Care Compare)

125 W Castellano Dr
El Paso, TX 79912-6108
Phone (915) 532-8200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43042OKMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso CurrentSince May 1, 2013 Accepting new patients
Ou Health Partners, Inc CurrentSince May 4, 2024 Accepting new patients
Ou Health Partners, Inc CurrentSince May 4, 2024 Accepting new patients
Texas Tech University Health Sciences Center El Paso Anesthesiology CurrentSince May 1, 2013 Accepting new patients
Children'S Physician Services of South Texas CurrentSince Jan 1, 2024 Accepting new patients
Children'S Physician Services of South Texas CurrentSince Jan 1, 2024 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Guide Anesthesia TX PLLC Anesthesiology CurrentSince Aug 26, 2024 Accepting new patients
Providence Imaging Consultants, P.a. Past Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

920 Stanton L Young Blvd
#1140
Oklahoma City, OK 73104
Phone (405) 271-4515

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

3533 S Alameda St
Ste 203
Corpus Christi, TX 78411

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

125 W Castellano Dr
El Paso, TX 79912
Phone (915) 532-8200

4800 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5666

Interoperability endpoints

  • Direct secure messaging: kristyn.ingram@direct.myhealthep.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1770765901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26901",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731260901",
            "telephone_number": "405-271-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 STANTON L YOUNG BLVD # WP1140",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045036",
            "telephone_number": "405-271-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "KRISTYN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "43042",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "N8667",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "N8667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302497802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302497801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60826576",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.