NPIMap

Organization Active NPI

Tri State Urologic Services PSC Inc

Doing business as The Urology Group

  • Urology Physician
  • Fairfield, OH
National Provider Identifier
1073746459
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
TRI STATE UROLOGIC SERVICES PSC INC
Doing business as
The Urology Group
Practice address
925 Deis Dr
Fairfield, OH 45014-8130
Phone
(513) 841-7900
Fax
(513) 841-7901
NPI assigned
Sep 1, 2009
Last updated
Mar 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Authorized official

Name
Earl L Walz
Title
Ceo
Phone
(513) 841-7400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

925 Deis Dr
Fairfield, OH 45014-8130

Mailing address

2000 Joseph E Sanker Blvd
Cincinnati, OH 45212-1979
Phone (513) 841-7400

Other practice location 1

2449 Ross Millville Rd Ste 265
Hamilton, OH 45013-8952
Phone (513) 841-7900

Other identifiers 2

IdentifierTypeStateIssuer
CC2433OtherOHRAILROAD MEDICARE
0276946MedicaidOH

Other names 1

  • THE UROLOGY GROUP Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031118000285 OH Part B Supplier - Clinic/Group Practice 6204740889 Receives reassigned benefits from 87 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilmington, OH; West Chester, OH; Oxford, OH; Middletown, OH; Hamilton, OH; Fairfield, OH; Cincinnati, OH; Blue Ash, OH
O20100930058680 OH DME Supplier - Physician - Urology 6204740889 Practice locations: Fairfield, OH

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1073746459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 JOSEPH E SANKER BLVD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452121979",
            "telephone_number": "513-841-7400",
            "fax_number": "513-841-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 DEIS DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450148130",
            "telephone_number": "513-841-7900",
            "fax_number": "513-841-7901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2449 Ross Millville Rd Ste 265",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450138952",
            "country_code": "US",
            "telephone_number": "513-841-7900",
            "fax_number": "513-841-7901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRI STATE UROLOGIC SERVICES PSC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-01",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "WALZ",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-841-7400"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC2433",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0276946",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "THE UROLOGY GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THE UROLOGY GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.