Active NPI
Tyler Mattingly
- Anesthesiology Physician
- Louisville, KY
National Provider Identifier
1255952891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- TP209
- Practice address
- 500 S Preston St RM 305
Louisville, KY 40202-1702 - Phone
- (502) 852-8696
- NPI assigned
- May 6, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | TP209 | KY | Primary |
Addresses
Primary practice location
500 S Preston St RM 305
Louisville, KY 40202-1702
Mailing address
500 S Preston St RM 305
Louisville, KY 40202-1702
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
10 Woodbridge Ctr Dr
Suite 425
Woodbridge, NJ 07095-1170
425 Lewis Hargett Cir
Lexington, KY 40503-3590
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783296000000",
"number": "1255952891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S PRESTON ST RM 305",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S PRESTON ST RM 305",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021702",
"telephone_number": "502-852-8696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTINGLY",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-06",
"last_updated": "2026-07-06",
"certification_date": "2026-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "KY",
"license": "TP209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.