CROSSROADS TREATMENT CENTERS TYLER
NPI 1104144088
Clinic/Center - Methadone in Tyler, TX
NPI Status: Active since May 17, 2010
Contact Information
1510 S VINE AVE
TYLER, TX
ZIP 75701
Phone: (800) 805-6989
- Organization
- Clinic/Center
- Methadone
- Accepts Insurance
- CLIA Number: 45D2181370
- CLIA Cert. Type: Other - OPIOD TREATMENT CTR
- CLIA Exp. Date: 04-01-2028
About CROSSROADS TREATMENT CENTERS TYLER
This page provides the complete NPI Profile along with additional information for Crossroads Treatment Centers Tyler, a provider established in Tyler, Texas operating as a Clinic/center, focusing in methadone . The healthcare provider is registered in the NPI registry with number 1104144088 assigned on May 2010. The practitioner's primary taxonomy code is 261QM2800X with license number 000039 (TX). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Crossroads Treatment Centers Tyler. The authorized official of this NPI record is Rupert Mccormac Md (Chief Executive Officer)
- NPI
- 1104144088
- Provider Legal Name
- METHADONE CLINIC OF EAST TEXAS LLC
- Other Organization Name
- CROSSROADS TREATMENT CENTERS TYLER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1510 S VINE AVE TYLER, TX 75701
- Location Phone
- (800) 805-6989
- Mailing Address
- PO BOX 749057 ATLANTA, GA 30374
- Mailing Phone
- (800) 805-6989
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-17-2010
- Last Update Date
- 09-03-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Methadone
- Taxonomy Code
- 261QM2800X
- Type
- Ambulatory Health Care Facilities
- License No.
- 000039
- License State
- TX
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 251S00000X | Agencies | Community/Behavioral Health | |
| 2 | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | |
| 3 | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | |
| 4 | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | |
| 5 | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | (TX) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoice) + Vision + Adult Dental - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
- Enhanced Diabetes Care Silver with $0 Drug Options - PPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2121550 | MEDICAID (05) | TX |
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Each additional 30 minutes of counseling in a week of medication assisted treatment, (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
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 treatm
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 for
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 procedure
This refers to extended counseling sessions in a week for patients undergoing medication-assisted treatment for opioid addiction. Provided by a Medicare-enrolled program, this service is billed separately from the main treatment procedure. It offers extra support and guidance for patients in their recovery journey.
This service was performed 27 times for 12 patientsMedication Assisted Treatment (MAT) with methadone is a comprehensive approach to manage opioid addiction. It includes weekly methadone dispensing, substance use counseling, individual and group therapy sessions, and toxicology tests as needed, all provided by a Medicare-enrolled opioid treatment program.
This service was performed 537 times for 22 patientsPeriodic assessment is a routine check-up by trained professionals to determine the best mix of services and treatments for your health needs. This is typically provided by a Medicare-enrolled opioid treatment program. It's listed separately in addition to your main treatment code. This ensures you receive the most suitable care for your situation.
This service was performed 16 times for 16 patientsThis service provides an additional 7-day supply of methadone, a medication used to treat opioid addiction, for patients to take at home. It's provided by a Medicare-enrolled opioid treatment program. This service is billed separately from the main treatment procedure.
This service was performed 399 times for 17 patientsCLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D2181370
- Facility Type
- Other - OPIOD TREATMENT CTR
- Certificate Effective Date
- April 02, 2026
- Certificate Expiration Date
- April 01, 2028
- Laboratory Director
- JAMES STEPHEN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Crossroads Treatment Centers Tyler to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104144088, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
TYLER, TX 75701
TYLER, TX 75701
TYLER, TX 75701
TYLER, TX 75701
TYLER, TX 75701
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104144088, enumerated as an "organization" on May 17, 2010.
The provider is located at 1510 S VINE AVE TYLER, TX 75701 and the phone number is (800) 805-6989.
Clinic/Center with taxonomy code 261QM2800X and a focus in Methadone.
The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.
