Individual provider Active NPI

Tyler Mancil, DPM

  • Foot & Ankle Surgery Podiatrist
  • Slidell, LA
National Provider Identifier
1154871275
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
DPM.200077 Issued in LA
Practice address
1150 Robert Blvd Ste 190
Slidell, LA 70458-2064
Phone
(985) 649-0002
Fax
(985) 649-0034
NPI assigned
Oct 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X DPM.200077 LA Primary

Addresses

Primary practice location

1150 Robert Blvd Ste 190
Slidell, LA 70458-2064

Mailing address

1150 Robert Blvd Ste 190
Slidell, LA 70458-2064
Phone (985) 649-0002

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170619001526 LA Practitioner - Podiatry 8022386945 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1001 Gause Blvd
Slidell, LA 70458-2939
Phone (985) 646-5970

Hospital & facility affiliations

  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
  • Slidell Memorial Hospital Hospital, Slidell, LA, CCN 190040
  • Ochsner Medical Center-Hancock Hospital, Bay Saint Louis, MS, CCN 250162

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue27
Removal of skin lesions23
Removal of nail tissue42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Aug 17, 2020 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Slidell Memorial Hospital CurrentSince Dec 31, 2018 Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 17, 2020 Accepting new patients
Slidell Memorial Hospital Past Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

100 Medical Center Dr
Slidell, LA 70461
Phone (504) 392-3131

1150 Robert Blvd
Ste 190
Slidell, LA 70458
Phone (985) 646-4415

1120 Robert Blvd
Ste 200
Slidell, LA 70458
Phone (985) 646-2223

1001 Gause Blvd
Slidell, LA 70458
Phone (985) 280-2200

Interoperability endpoints

  • Direct secure messaging: mancil.tyler.001.0180017@wdpmsa.meditab.direct-ci.com

Organizations & group practices 5

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 3

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": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1154871275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 ROBERT BLVD STE 190",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582064",
            "telephone_number": "985-649-0002",
            "fax_number": "985-649-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 ROBERT BLVD STE 190",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582064",
            "telephone_number": "985-649-0002",
            "fax_number": "985-649-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCIL",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-12",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "LA",
            "license": "DPM.200077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.