Kyle J Mangels MD, PLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

KYLE J MANGELS MD, PLC

Practice address

6802 S Olympia Ave Ste 275
Tulsa, OK 74132-1848

Phone

(918) 600-0327

Fax

(918) 732-9229

NPI assigned

Feb 4, 2021

Organization subpart

No

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

Authorized official

Name

Brittney Payne

Title

Office Manager

Phone

(918) 600-0327

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 2

• KM Neurosurgery Clinic Doing business as
• Kyle J Mangels MD, PLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Oklahoma Spine and Brain Institute, LLP

  • Neurological Surgery Physician
  • Tulsa, OK
  • NPI 1588625339

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle Joe Mangels, M.D.

  • Specialist
  • Tulsa, OK
  • NPI 1174585640
  Medicare reassignment Care Compare group NPD
• Kristi A Krebs, PA

  • Surgical Physician Assistant
  • Tulsa, OK
  • NPI 1770815748
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1902498686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE STE 275",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321848",
            "telephone_number": "918-600-0327",
            "fax_number": "918-732-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE STE 275",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321848",
            "telephone_number": "918-600-0327",
            "fax_number": "918-732-9229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 2nd Ave SW Ste 205",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "OK",
            "postal_code": "743546702",
            "country_code": "US",
            "telephone_number": "918-600-0327",
            "fax_number": "918-732-9229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "213 E Redwood Ave",
            "address_purpose": "LOCATION",
            "city": "Sallisaw",
            "state": "OK",
            "postal_code": "749552811",
            "country_code": "US",
            "telephone_number": "918-600-0327",
            "fax_number": "918-732-9229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KYLE J MANGELS MD, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "BRITTNEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "918-600-0327"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1902498686",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10885134",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100138240A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1902498686",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOVITAS SOLUTIONS",
            "identifier": "1902498686",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KM Neurosurgery Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kyle J Mangels MD, PLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Christina Carlee Kuykendall, MA
• David Yin-Lun Kwok
• Julia Margaret Kwon, DO
• Ky Medservices LLC
• Kyle a. Wilson, D.O., LLC
• Emily Anne Kymes
• L & L Pharmacy LLC
• L Christopher DDS PC
• L Keith Simmons DO PLLC
• James Omer L'Esperance, M.D.

• Specialist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.