Methadone Clinic of East Texas LLC
NPI 1104144088 · Methadone Clinic · Tyler, TX
Enrolled with Medicare as Part B Supplier - Opioid Treatment Program (otp) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Methadone Clinic of East Texas LLC is a Methadone Clinic organization in Tyler, TX (NPI 1104144088).
Provider details
- NPI number
- 1104144088
- Entity type
- Organization
- Primary specialty
- Methadone ClinicAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Rupert Mccormac, Chief Executive Officer(800) 805-6898
Specialties & taxonomies
Ambulatory Health Care Facilities
- Community/Behavioral Health Agency251S00000X
Agencies
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
16 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
1,018 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Medication Assisted Treatment, Methadone; Weekly Bundle Including Dispensing And/Or Administration, Substance Use Counseling, Individual and Group Therapy, and Toxicology Testing, If Performed (provision of the Services By a Medicare-Enrolled Opioid TreatmG2067 | 517 | $249 |
| Take-Home Supply of Methadone; Up to 7 Additional Day Supply (provision of the Services By a Medicare-Enrolled Opioid Treatment Program); List Separately in Addition to Code for Primary ProcedureG2078 | 481 | $40 |
| Periodic Assessment; Assessing Periodically By Qualified Personnel to Determine the Most Appropriate Combination of Services and Treatment (provision of the Services By a Medicare-Enrolled Opioid Treatment Program); List Separately in Addition to Code forG2077 | 20 | $118 |
Typical Medicare-allowed amounts for these services range $40–$249 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Crossroads Treatment Centers Tyler
Registry dates
- Enumerated
- 2010-05-17
- Last updated
- 2024-09-03
- Certified
- 2024-09-03
Frequently asked questions
- What is Methadone Clinic of East Texas LLC's NPI number?
- Methadone Clinic of East Texas LLC's National Provider Identifier (NPI) is 1104144088, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Methadone Clinic of East Texas LLC?
- Methadone Clinic of East Texas LLC is classified in the NPPES registry as Methadone Clinic (Ambulatory Health Care Facilities).
- Where is Methadone Clinic of East Texas LLC located?
- Methadone Clinic of East Texas LLC's practice location on file with NPPES is 1510 S Vine Ave, Tyler, TX 75701-2826.
- What is Methadone Clinic of East Texas LLC's phone number?
- The practice phone number listed in the NPPES registry for Methadone Clinic of East Texas LLC is (800) 805-6989.
- Does Methadone Clinic of East Texas LLC accept Medicare?
- Methadone Clinic of East Texas LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Methadone Clinic of East Texas LLC?
- The authorized official listed on Methadone Clinic of East Texas LLC's NPPES record is Rupert Mccormac, Chief Executive Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Methadone Clinic of East Texas LLC's NPI active?
- Yes — Methadone Clinic of East Texas LLC's NPI (1104144088) is active in the NPPES registry as of the last update on 2024-09-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.