Mark S Lisch, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0787 Issued in TX

Practice address

6816 Shadow Creek CT
Fort Worth, TX 76132-4522

Phone

(832) 368-6841

NPI assigned

Feb 23, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1124094958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16918",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761620918",
            "telephone_number": "323-686-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6816 SHADOW CREEK CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324522",
            "telephone_number": "832-368-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISCH",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "0787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085279001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82Y991",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092841802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cary Linzy, COUNSELOR
• Brianna Lipps, PTA
• Brian Bernard Lipscomb, LVN
• Thomas Stanley Lipscomb, M.D.
• Lisa M Buell, M.D., P.a.
• Stella A. Lisk, RN, BC, FNP
• Shannon Listebarger, MPT
• Alan Scott Littenberg
• Little Boots Pediatric Dentistry
• Little Champs ABA TX LLC

• Podiatrist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.