Individual provider Active NPI

Balminder S Mangat, MD

  • Psychiatry Physician
  • Slidell, LA
National Provider Identifier
1114974151
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
05867R Issued in LA
Practice address
1924 Corporate Square Dr Ste C
Slidell, LA 70458-3164
Phone
(985) 649-2576
Fax
(985) 735-9105
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 05867R LA Primary

Addresses

Primary practice location

1924 Corporate Square Dr Ste C
Slidell, LA 70458-3164

Mailing address

1924 Corporate Square Dr
Slidell, LA 70458-3164
Phone (985) 649-2576

Other identifiers 1

IdentifierTypeStateIssuer
1342661MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051215000660 LA Practitioner - PsychiatryPractitioner - Geriatric PsychiatryPractitioner - Addiction Medicine 0840211058 Practice locations: Slidell, LA

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1924 Corporate Square Dr
Slidell, LA 70458-3164
Phone (985) 649-2576

Hospital & facility affiliations

  • Slidell Memorial Hospital Hospital, Slidell, LA, CCN 190040

National Provider Directory

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

Practice roles (1 of 2)

OrganizationSpecialtyStatusNew patients
Gulf South Psychiatry, LLC PastSince Feb 13, 2022 Accepting new patients

Networks

  • LA PPO C-SNP

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1114974151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 CORPORATE SQUARE DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704583164",
            "telephone_number": "985-649-2576",
            "fax_number": "985-735-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 CORPORATE SQUARE DR STE C",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704583164",
            "telephone_number": "985-649-2576",
            "fax_number": "985-735-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGAT",
        "first_name": "BALMINDER",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "05867R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1342661",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.