- Medicare Podiatrist in Liberty, TX

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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.

is licensed to practice in Texas (license number 506) and it also participates in the medicare program. 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.

Contact Information

1825 Grand Ave,
Liberty, TX 77575-4705
(936) 336-2633
(936) 336-6031

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityPodiatrist
Location1825 Grand Ave, Liberty, Texas
Accepts Medicare AssignmentsMedicare 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 such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689603805NPI-NPPES
DG6815OtherTXRR MEDICARE
00J24POtherTXBCBS
121574103MedicaidTX
199497201MedicaidTX

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
213E00000XPodiatrist 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. acts as a billing entity for following providers:
Provider NameLawrence S Mactavish
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1104858885
PECOS PAC ID: 1951363498
Enrollment ID: I20041027001265
Provider NameLawrence S Mactavish
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI 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. 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

Po Box 1160,
Liberty, TX 77575-1160

Ph: (281) 444-4114
1825 Grand Ave,
Liberty, TX 77575-4705

Ph: (936) 336-2633

Reviews and Comments


Podiatrist in Liberty, TX


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.