Ingenious Personalized Medicine, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

INGENIOUS PERSONALIZED MEDICINE, LLC

Practice address

9218 Kimmer Dr Ste 200
Lone Tree, CO 80124-6733

Phone

(786) 221-1734

Fax

(305) 891-4228

NPI assigned

Jan 9, 2023

Last updated

Jan 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott Daniel Segal, MDNPI 1821086323

Title

Ceo

Phone

(888) 852-6672

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Ingenious Personalized Medicine, LLC

  • Clinical Medical Laboratory
  • North Miami, FL
  • NPI 1598161846

  3971810854

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Ingenious Personalized Medicine, LLC

  • Clinical Medical Laboratory
  • North Miami, FL
  • NPI 1598161846

  O20150910001161

  Same enrollment

Tax ID family

Ingenious Personalized Medicine LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Ingenious Personalized Medicine, LLC

  • Clinical Medical Laboratory
  • Colorado Springs, CO
  • NPI 1083280978
  NPD tax ID
• Ingenious Personalized Medicine, LLC

  • Clinical Medical Laboratory
  • Tallahassee, FL
  • NPI 1669141230
  NPD tax ID

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Scott Segal, MD

  • Psychiatry Physician
  • North Miami, FL
  • NPI 1821086323
  NPD (past) Authorized official
• Esteban Cardonne, M.D.

  • Psychiatry Physician
  • South Miami, FL
  • NPI 1962886788
  NPD (past)
• Asha Davis, M.D.

  • Psychiatry Physician
  • Washington, DC
  • NPI 1811177249
  NPD (past)
• Argentino Antonio Di Luigi, MD

  • Psychiatry Physician
  • Boynton Beach, FL
  • NPI 1689662181
  NPD (past)
• Vladymir Gratia

  • Psychiatric/Mental Health Nurse Practitioner
  • West Palm Beach, FL
  • NPI 1760024871
  NPD (past)
• Curtis Phillips, MD

  • Addiction Psychiatry Physician
  • Delray Beach, FL
  • NPI 1811285737
  NPD (past)

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1982318671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 NE 125TH ST STE 300",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615833",
            "telephone_number": "786-221-0908",
            "fax_number": "305-891-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9218 KIMMER DR STE 200",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801246733",
            "telephone_number": "786-221-1734",
            "fax_number": "305-891-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGENIOUS PERSONALIZED MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "SEGAL",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-852-6672",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Clinical Medical Laboratory in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.