NPIMap

Organization Active NPI

Tri-State Health, Inc.

  • Specialist
  • Elkton, MD
National Provider Identifier
1255409082
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
TRI-STATE HEALTH, INC.
Practice address
107 N Bridge St
Elkton, MD 21921-5326
Phone
(410) 392-6408
Fax
(410) 392-6409
NPI assigned
Dec 1, 2006
Last updated
Feb 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Authorized official

Name
Muhammed A Niaz, M.D.NPI 1255338869
Title
Owner
Phone
(410) 392-6408

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Specialist 174400000X Primary
Internal Medicine Physician 207R00000X
Addiction Medicine (Internal Medicine) Physician 207RA0401X
Sleep Medicine (Internal Medicine) Physician 207RS0012X

Addresses

Primary practice location

107 N Bridge St
Elkton, MD 21921-5326

Mailing address

107 N Bridge St
Elkton, MD 21921-5326
Phone (410) 392-6408

Other identifiers 1

IdentifierTypeStateIssuer
401409000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070614000071 DE Part B Supplier - Clinic/Group Practice 0143328153 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Newark, DE
O20101210001040 MD Part B Supplier - Clinic/Group Practice 0143328153 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Colora, MD; North East, MD; Elkton, MD

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

2288 Pulaski Hwy
Ste 1
North East, MD 21901
Phone (410) 392-6408

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1255409082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N BRIDGE ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215326",
            "telephone_number": "410-392-6408",
            "fax_number": "410-392-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N BRIDGE ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215326",
            "telephone_number": "410-392-6408",
            "fax_number": "410-392-6409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "NIAZ",
        "authorized_official_first_name": "MUHAMMED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-392-6408",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401409000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.