NPIMap

Organization Active NPI

Tri State Anesthesia, P.C

  • Anesthesiology Physician
  • Montvale, NJ
National Provider Identifier
1134426182
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
TRI STATE ANESTHESIA, P.C
Practice address
133 N Kinderkamack Rd
Montvale, NJ 07645
Phone
(845) 357-5775
Fax
(845) 357-5777
NPI assigned
Feb 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Authorized official

Name
Richard P. Clarkin, MDNPI 1205884509
Title
President
Phone
(845) 357-5775

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

133 N Kinderkamack Rd
Montvale, NJ 07645

Mailing address

100 Route 59 Ste 111
Suffern, NY 10901-4927
Phone (845) 357-5775

Other identifiers 1

IdentifierTypeStateIssuer
223834OtherNJMEDICARE

National Provider Directory

National Provider Directory

Locations

137 N Kinderkamack Rd
Montvale, NJ 07645
Phone (201) 307-4810

100 Route 59
Ste 105
Suffern, NY 10901
Phone (845) 357-5745

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1298678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535414400000",
    "number": "1134426182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROUTE 59 STE 111",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014927",
            "telephone_number": "845-357-5775",
            "fax_number": "845-357-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 N KINDERKAMACK RD",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "07645",
            "telephone_number": "845-357-5775",
            "fax_number": "845-357-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE ANESTHESIA, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-26",
        "last_updated": "2018-08-28",
        "status": "A",
        "authorized_official_last_name": "CLARKIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-357-5775",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "223834",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montvale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.