Allen Tisch, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

105400-1 Issued in NY

Practice address

268 Mountain Rd
Cornwall on Hudson, NY 12520-1806

Phone

(845) 534-2328

NPI assigned

Dec 31, 2007

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DGICBA

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.

• Cataract & Laser Eye Surgeons of Hudson Valley PC

  • Specialist
  • Cornwall, NY
  • NPI 1689607244
  NPD (past)
• Horizon Medical Group, P.C.

  • Family Medicine Physician
  • Goshen, NY
  • NPI 1063488179
  NPD (past)

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199059200000",
    "number": "1053596734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 MOUNTAIN RD",
            "city": "CORNWALL ON HUDSON",
            "state": "NY",
            "postal_code": "125201806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 MOUNTAIN RD",
            "city": "CORNWALL ON HUDSON",
            "state": "NY",
            "postal_code": "125201806",
            "telephone_number": "845-534-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISCH",
        "first_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "105400-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00519668",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "AT0587201",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Patrick Stewart, RN
• Melissa Stoffa, LCSW
• Damaris Summo, LMT
• The Hudson Center
• Kelly Suzanne Theis, M.S. SLP
• Irene Vonestorff, MD
• Marie Warchol, LCSW
• Jennifer Sayegh Wilcox, MS, RDN, LDN
• Elizabeth Sarah Wingfield, CCC-SLP
• Arya Michael Yarpezeshkan

• Ophthalmology Physician in Cornwall on Hudson, NY
• Providers in Cornwall on Hudson, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.