Liberty Dayton Foot & Ankle Center is a medicare enrolled "Podiatrist" provider in Liberty, Texas. Their current practice location is
1825 Grand Ave, Liberty, Texas. You can reach out to their office (for appointments etc.) via phone at
(936) 336-2633.
Liberty Dayton Foot & Ankle Center is licensed to practice in Texas (license number 506) and it also participates in the medicare program. Liberty Dayton Foot & Ankle Center
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1689603805.
Healthcare Provider's Profile
| Full Name | Liberty Dayton Foot & Ankle Center |
|---|
| Type | Facility |
|---|
| Speciality | Podiatrist |
|---|
| Location | 1825 Grand Ave, Liberty, Texas |
|---|
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1689603805
- Provider Enumeration Date: 07/01/2006
- Last Update Date: 06/19/2009
Medicare PECOS Information:
- PECOS PAC ID: 6507867934
- Enrollment ID: O20070126000449
Medical Identifiers
Medical identifiers for Liberty Dayton Foot & Ankle Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1689603805 | NPI | - | NPPES |
| DG6815 | Other | TX | RR MEDICARE |
| 00J24P | Other | TX | BCBS |
| 121574103 | Medicaid | TX | |
| 199497201 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213E00000X | Podiatrist | 506 (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.
Liberty Dayton Foot & Ankle Center acts as a billing entity for following providers:
| Provider Name | Lawrence S Mactavish |
|---|
| Provider Type | Practitioner - Podiatry |
|---|
| Provider Identifiers | NPI Number: 1104858885
PECOS PAC ID: 1951363498
Enrollment ID: I20041027001265 |
|---|
| Provider Name | Lawrence S Mactavish |
|---|
| Provider Type | Practitioner - Podiatry |
|---|
| Provider Identifiers | NPI Number: 1588609408
PECOS PAC ID: 0345253324
Enrollment ID: I20060714000163 |
|---|
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. Liberty Dayton Foot & Ankle Center 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 Address | Practice Location Address |
|---|
Liberty Dayton Foot & Ankle Center
Po Box 1160,
Liberty, TX 77575-1160
Ph: (281) 444-4114 | Liberty Dayton Foot & Ankle Center
1825 Grand Ave,
Liberty, TX 77575-4705
Ph: (936) 336-2633 |
Reviews and Comments