Tri-State Eye Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

TRI-STATE EYE INC

Practice address

396 Route 6 and 209 Ste 1
Milford, PA 18337-9490

Phone

(570) 296-9696

Fax

(570) 409-0316

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Severin Bohdan Palydowycz, MDNPI 1215939483

Title

Owner

Phone

(570) 296-9696

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NY, NJ3 enrollments

Enrollment records 3

Locations

Practitioners 8

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.

• Severin Bohdan Palydowycz, MD

  • Specialist
  • Milford, PA
  • NPI 1215939483

  NJ, NY

  Medicare reassignment Care Compare group NPD Authorized official
• Joseph Michael Haggerty, OD

  • Optometrist
  • Milford, PA
  • NPI 1629070875
  Medicare reassignment Care Compare group NPD
• Lawrence I Ross, MD

  • Ophthalmology Physician
  • Woodbury, NY
  • NPI 1013956796

  PA

  Medicare reassignment Care Compare group NPD
• Marcin Marek Zygawski, M.D.

  • Ophthalmology Physician
  • Pittsfield, MA
  • NPI 1396747556

  NY

  Medicare reassignment
• Joshua I Riber, M.D.

  • Specialist
  • Pomona, NY
  • NPI 1578611331
  NPD (past)
• Shaun Stuart Shafer, M.D.

  • Ophthalmology Physician
  • Laramie, WY
  • NPI 1730181561
  NPD (past)
• Michael G Tedford I, M.D.

  • Ophthalmology Physician
  • Newburgh, NY
  • NPI 1750453742
  NPD (past)
• Marc Von Roemer, MD

  • Specialist
  • Lakewood, NJ
  • NPI 1841200862
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1255450581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 ROUTE 6 AND 209 STE 1",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183379490",
            "telephone_number": "570-296-9696",
            "fax_number": "570-409-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 ROUTE 6 AND 209 STE 1",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183379490",
            "telephone_number": "570-296-9696",
            "fax_number": "570-409-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE EYE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "PALYDOWYCZ",
        "authorized_official_first_name": "SEVERIN",
        "authorized_official_middle_name": "BOHDAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-296-9696",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Milford, PA
• Providers in Milford, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.