Active NPI
Tedrick Mangassarian, D.O.
- Student in an Organized Health Care Education/Training Program
- New Orleans, LA
National Provider Identifier
1851148845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2020 Gravier St
New Orleans, LA 70112-2272 - Phone
- (504) 568-2577
- NPI assigned
- May 6, 2024
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
2020 Gravier St
New Orleans, LA 70112-2272
Mailing address
2020 Gravier St
New Orleans, LA 70112-2272
Phone (818) 523-4647
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240621003690 | LA | Order and Referring Only - Physical Medicine and Rehabilitation | 0648713313 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765929600000",
"number": "1851148845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 GRAVIER ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701122272",
"telephone_number": "818-523-4647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 GRAVIER ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701122272",
"telephone_number": "504-568-2577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGASSARIAN",
"first_name": "TEDRICK",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-06",
"last_updated": "2025-12-17",
"certification_date": "2025-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.