Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brian R Ingram, PA

Individual provider Physician Assistant · NPI 1700368495

Brian R Ingram, PA is a Physician Assistant in Edgewood, New Mexico. Qualified in 2018, 8 years ago. Practices with H2 Rehabilitation Services of Virginia, LLC, a 67-clinician group and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
8
Licensed in
NM
In the registry since
2018
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

1851 Old Hwy 66
Edgewood, NM 87015
Phone: (505) 286-2396
Fax: (505) 286-2398
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA2018-0050 (NM)

Record details

NPI number1700368495
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 30, 2018
Last updated in NPPESAugust 30, 2018
Mailing address12127b Hwy 14 N Ste 5, Cedar Crest, NM 87008-9499

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice H2 Rehabilitation Services Of Virginia, Llc — 67 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Edgewood