Samuel Kullen Mancil

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11254 Issued in LA

Practice address

208 W McNeese St
Lake Charles, LA 70605-5638

Phone

(337) 824-5488

NPI assigned

Feb 16, 2023

Last updated

Feb 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moreau Physical Therapy Inc.Group PAC ID 3173419298, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Moreau Physical Therapy Inc.

  dba Moreau Physical Therapy

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1770568669
  Medicare reassignment Care Compare group NPD
• Calcasieu Therapy Group LLC

  • Physical Therapist
  • Moss Bluff, LA
  • NPI 1487085320
  Medicare reassignment NPD
• Iowa Therapy Group LLC

  • Physical Therapist
  • Iowa, LA
  • NPI 1578617924
  Medicare reassignment NPD
• Southwest Louisiana Sports and Rehabilitation Center, LLC

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1841357761
  Medicare reassignment NPD
• Thibodeaux, Albro & Touchet Therapy Group, LLC

  • Physical Therapist
  • Jennings, LA
  • NPI 1104973262
  Medicare reassignment NPD
• Lake Charles Sports & Rehab

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1194301317
  NPD
• Alvin C Moreau Jr Licensed Physical Therapist DTD 01 15 82

  dba Moreau Physical Therapy

  • Physical Therapist
  • Beaumont, TX
  • NPI 1831962018
  NPD

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

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1679271977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 ELTON RD STE I",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705464100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055638",
            "telephone_number": "337-824-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCIL",
        "first_name": "SAMUEL",
        "middle_name": "KULLEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "11254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malve Management Solutions LLC
• Danella Malveaux, NP
• Jacinda Malveaux, LAC
• Keonah A Malveaux
• Stephanie Malveaux
• Manpreet Mand, M.D.
• Sandra Lynn Manela
• Yvonne Marie Manning-Smith, MHP
• Brittany Antraneque Manuel
• Cheryl Manuel, RN, CCM

• Physical Therapist in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.