Individual provider Active NPI

Gary L. Erickson, D.P.M.

  • Podiatrist
  • Fort Worth, TX
National Provider Identifier
1841290012
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
801 Issued in TX
Practice address
910 W Northside Dr
Fort Worth, TX 76164-9046
Phone
(817) 926-5287
Fax
(817) 926-5288
NPI assigned
Jul 28, 2005
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 801 TX Primary

Addresses

Primary practice location

910 W Northside Dr
Fort Worth, TX 76164-9046

Mailing address

921 Ryanfield CT
Burleson, TX 76028-8109
Phone (817) 926-5287

Other identifiers 1

IdentifierTypeStateIssuer
018832801MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070323000509 TX Practitioner - Podiatry 0345344750 Practice locations: Fort Worth, TX

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2463 Forest Park Blvd
Fort Worth, TX 76110-1731

910 W Northside Dr
Fort Worth, TX 76164-9046
Phone (817) 926-5287

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
801TXMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1841290012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 RYANFIELD CT",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760288109",
            "telephone_number": "817-926-5287",
            "fax_number": "817-926-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 W NORTHSIDE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761649046",
            "telephone_number": "817-926-5287",
            "fax_number": "817-926-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "GARY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018832801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.