Dr Eric Leif Gustafson, MD - Medicare Family Medicine in Fort Worth, TX

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Dr Eric Leif Gustafson, MD is a medicare enrolled "Family Medicine" physician in Fort Worth, Texas. His current practice location is 3924 Drexmore Rd, Fort Worth, Texas. You can reach out to his office (for appointments etc.) via phone at (936) 933-9583.

Dr Eric Leif Gustafson is licensed to practice in Texas (license number T3627) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1689171035.

Contact Information

Dr Eric Leif Gustafson, MD
3924 Drexmore Rd,
Fort Worth, TX 76244-8510
(936) 933-9583
Not Available

Map and Direction




Physician's Profile

Full NameDr Eric Leif Gustafson
GenderMale
SpecialityFamily Medicine
Location3924 Drexmore Rd, Fort Worth, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1689171035
  • Provider Enumeration Date: 04/11/2018
  • Last Update Date: 05/03/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 3173900917
  • Enrollment ID: I20220516002405

Medical Identifiers

Medical identifiers for Dr Eric Leif Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689171035NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine T3627 (Texas)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Eric Leif Gustafson allows following entities to bill medicare on his behalf.
Entity NameMuenster Hospital District
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972556009
PECOS PAC ID: 6608785993
Enrollment ID: O20031106000571
Entity NameFisher County Hospital District
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104808112
PECOS PAC ID: 2163311465
Enrollment ID: O20040315000096
Entity NameSutton County Hospital District
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1831140979
PECOS PAC ID: 9032102678
Enrollment ID: O20040407001383
Entity NameNorth Wheeler County Hospital District
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396748471
PECOS PAC ID: 1254327232
Enrollment ID: O20040423001044
Entity NameBallinger Memorial Hospital District
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1225038938
PECOS PAC ID: 0042200180
Enrollment ID: O20040512001286
Entity NameConcord Medical Group Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083630610
PECOS PAC ID: 0446296818
Enrollment ID: O20050707000531
Entity NameConcho County Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134166226
PECOS PAC ID: 3971505298
Enrollment ID: O20070815000340
Entity NameConcord Medical Group Of Texas Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750790762
PECOS PAC ID: 7810117223
Enrollment ID: O20141007002567
Entity NameAltus Exceptional Physician Group Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730869207
PECOS PAC ID: 0042662462
Enrollment ID: O20240122000381

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Eric Leif Gustafson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Eric Leif Gustafson, MD
3924 Drexmore Rd,
Fort Worth, TX 76244-8510

Ph: () -		Dr Eric Leif Gustafson, MD
3924 Drexmore Rd,
Fort Worth, TX 76244-8510

Ph: (936) 933-9583

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.