NPIMap

Individual provider Active NPI

Ty Glenn Hargroder, MD

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Eunice, LA
National Provider Identifier
1093761645
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
020601 Issued in LA
Practice address
3501 Highway 190 Ste X
Eunice, LA 70535-5129
Phone
(337) 580-7544
NPI assigned
May 25, 2006
Last updated
May 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 020601 LA
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 020601 LA Primary

Addresses

Primary practice location

3501 Highway 190 Ste X
Eunice, LA 70535-5129

Mailing address

PO Box 407
Church Point, LA 70525-0407
Phone (337) 684-5232

Other identifiers 4

IdentifierTypeStateIssuer
080166458OtherLARR MEDICARE
678856OtherLAAETNA
1398501MedicaidLA
72-1190076OtherLAIRS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071106000710 LA Practitioner - Hospice/Palliative CarePractitioner - Other (Physician) 0749376606 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Louisiana State University School of Medicine in New Orleans, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hargroder Medical, Inc.Group PAC ID 4385730241, 2 clinicians

Practice addresses (Care Compare)

3501 Hwy 190
Eunice, LA 70535-5129
Phone (337) 684-5232

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue44
Removal of skin lesions1-10
Removal of nail tissue68
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020601LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hargroder Medical, Inc. Family Medicine CurrentSince Oct 1, 1992 Accepting new patients
Acadia-St. Landry Hospital Service District CurrentSince Nov 7, 2011 Accepting new patients
CLHG-Acadian, LLC CurrentSince Jan 28, 2024 Accepting new patients
Acadia-St. Landry Hospital Service District Family Medicine CurrentSince Nov 7, 2011 Accepting new patients
CLHG-Acadian LLC Family Medicine CurrentSince Jan 28, 2024 Accepting new patients
CLHG-Acadian, LLC PastSince May 21, 2023 Accepting new patients
7 Pelicans LLC Past Accepting new patients
Opelousas Healthcare Properties LLC Past Accepting new patients

Locations

731 S Main St
Church Point, LA 70525
Phone (337) 684-0911

810 S Broadway St
Church Point, LA 70525
Phone (337) 684-4281

820 S Broadway St
Church Point, LA 70525
Phone (318) 684-5232

3501 Highway 190
Eunice, LA 70535
Phone (337) 580-7500

3501 Highway 190
#X
Eunice, LA 70535
Phone (318) 684-5232

3501 Highway 190
Ste X
Eunice, LA 70535
Phone (337) 580-7544

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEEJAD
  • FHIR API: https://fhir4.healow.com/fhir/r4/EEEJAD/Endpoint/EEEJAD

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1093761645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "CHURCH POINT",
            "state": "LA",
            "postal_code": "705250407",
            "telephone_number": "337-684-5232",
            "fax_number": "337-684-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 HIGHWAY 190 STE X",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705355129",
            "telephone_number": "337-580-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGRODER",
        "first_name": "TY",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "020601",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "LA",
            "license": "020601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080166458",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "678856",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1398501",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "72-1190076",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eunice, LA

Sources for this page

Verify at the official NPI Registry.