Individual provider Active NPI

Amy Beth Ingersoll, PA

  • Medical Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1811224694
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4464 Issued in AZ
Practice address
6900 E Camelback Rd Ste 850
Scottsdale, AZ 85251-2443
Phone
(480) 945-6777
Fax
(480) 481-5070
NPI assigned
Nov 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4464 AZ Primary

Addresses

Primary practice location

6900 E Camelback Rd Ste 850
Scottsdale, AZ 85251-2443

Mailing address

4702 E Mariposa St
Phoenix, AZ 85018-2840
Phone (480) 945-6777

Other practice location 1

4222 E Thomas Rd Ste 250
Phoenix, AZ 85018-7619
Phone (602) 772-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20091230000451 AZ Practitioner - Physician Assistant 3476694290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4464AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ancillary Care Strategies Physician Assistant CurrentSince May 18, 2020 Accepting new patients
Neurosurgical Associates, LTD Past Accepting new patients
Openloop Healthcare Partners PC Physician Assistant PastSince Oct 25, 2020 Accepting new patients

Locations

6900 E Camelback Rd
Ste 850
Scottsdale, AZ 85251
Phone (480) 206-6190

Organizations & group practices 3

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": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1811224694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 E MARIPOSA ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182840",
            "telephone_number": "480-945-6777",
            "fax_number": "480-481-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 E CAMELBACK RD STE 850",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852512443",
            "telephone_number": "480-945-6777",
            "fax_number": "480-481-5070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4222 E Thomas Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850187619",
            "country_code": "US",
            "telephone_number": "602-772-3800",
            "fax_number": "602-772-3801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGERSOLL",
        "first_name": "AMY",
        "middle_name": "BETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.