Albert I Tydings, MD
Individual provider Active NPI Gynecology Physician · Covington, LA
NPI 1952364705 · NPPES record last updated Feb 19, 2014
Key facts
- NPI
- 1952364705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gynecology Physician 207VG0400X
- License
- 10505 (LA)
- Practice address
- 121 Lakeview Cir
Suite C
Covington, LA 70433-7513 - Phone
- (985) 892-1111
- Fax
- (985) 892-1116
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
121 Lakeview Cir
Suite C
Covington, LA 70433-7521
Phone (985) 892-1111
Hospital & facility affiliations
- St Tammany Parish Hospital
- East Jefferson General Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101027000887 | LA | Practitioner - Obstetrics/Gynecology | 1759575434 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10505 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albert Tydings MD, Apmc | Current |
Accepting new patients | |
| University Healthcare System, L.C. | Past | Accepting new patients |
Locations
121 Lakeview Cir
Ste C
Covington, LA 70433
Phone (985) 892-1111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 10505 | LA | Yes |
Addresses
Primary practice location
121 Lakeview Cir
Suite C
Covington, LA 70433-7513
Mailing address
121 Lakeview Cir
Suite C
Covington, LA 70433-7513
Phone (985) 892-1111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1300446 | Medicaid | LA |
Other providers in Covington, LA
- Donald Allen Tumbleston Jr.
- Melissa Tumbleston
- Lexie Bordelon Tuminski
- Delanie J Turner
- Two Eagles N Spear LLC
- Ulrich a Starke MD LLC
- Carrie Marie Umberger
- Demeka Underwood
- University Healthcare System, L.C.
- University Healthcare Systems, LC
All providers in Covington, LA · Gynecology Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.