Individual provider Active NPI

Niti Manglik, M.B.B.S, M.D

  • Anatomic Pathology & Clinical Pathology Physician
  • Irving, TX
National Provider Identifier
1487944229
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
P8696 Issued in TX
Practice address
4770 Regent Blvd
Irving, TX 75063-2445
Phone
(972) 934-4300
NPI assigned
Apr 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology Physician 207ZC0006X P8696 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X P8696 TX Primary

Addresses

Primary practice location

4770 Regent Blvd
Irving, TX 75063-2445

Mailing address

14275 Midway Rd Ste 400
Addison, TX 75001-3614

Other practice location 1

4343 N Josey Ln
Carrollton, TX 75010-4603
Phone (972) 394-2236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160411002201 TX Practitioner - Pathology 8921306796 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P8696TXMDClinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waco Gastroenterology Associates Clinical Pathology CurrentSince Apr 1, 2025 Accepting new patients
DFW 501a Corporation Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2022 Accepting new patients
DFW 501a Corporation Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2022 Accepting new patients

Locations

14275 Midway Rd
Ste 400
Addison, TX 75001
Phone (214) 932-8018

4343 N Josey Ln
Carrollton, TX 75010
Phone (972) 394-2280

400 W Lyndon B Johnson Fwy
Ste 101
Irving, TX 75063
Phone (972) 868-4000

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

364 Richland West Cir
#A
Waco, TX 76712
Phone (254) 537-0911

Interoperability endpoints

  • Direct secure messaging: niti.manglik@direct.myhealthep.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1487944229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 REGENT BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632445",
            "telephone_number": "972-934-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4343 N Josey Ln",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "TX",
            "postal_code": "750104603",
            "country_code": "US",
            "telephone_number": "972-394-2236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGLIK",
        "first_name": "NITI",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S, M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "TX",
            "license": "P8696",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "P8696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.