NPIMap

Organization Active NPI

Tri State Urologic Services PSC Inc

  • Urology Physician
  • Crestview Hills, KY
National Provider Identifier
1275726580
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
Practice address
350 Thomas More Pkwy Ste 200
Crestview Hills, KY 41017-5460
Phone
(859) 363-2200
NPI assigned
Aug 20, 2007
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
Daniel Schraff
Title
Chief Financial Officer
Phone
(614) 339-3998

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary
Non-Pharmacy Dispensing Site 332900000X 26192 KY
Durable Medical Equipment & Medical Supplies 332B00000X
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

350 Thomas More Pkwy Ste 200
Crestview Hills, KY 41017-5460

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2158101OtherPK

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 KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040519000097 KY Part B Supplier - Clinic/Group Practice 6204740889 Receives reassigned benefits from 11 practitioners
Practice locations: Crestview Hills, KY
O20100930015677 KY DME Supplier - Physician - Urology 6204740889 Practice locations: Crestview Hills, KY

Other NPIs with the same Medicare PAC ID 7

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0324188Urology Group,the350 Thomas More Pkwy, Suite 200, Crestview Hills, KY 41017Provider-performed microscopyDec 16, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 75

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

View all 75

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1275726580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 JOSEPH 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": "350 THOMAS MORE PKWY STE 200",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175460",
            "telephone_number": "859-363-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE UROLOGIC SERVICES PSC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "SCHRAFF",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "614-339-3998"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "KY",
            "license": "26192",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158101",
            "state": null
        }
    ],
    "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 Crestview Hills, KY

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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.