Tri-State Surgical Associates

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

TRI-STATE SURGICAL ASSOCIATES

Practice address

10332 Main St # 344
Fairfax, VA 22030-2410

Phone

(571) 244-4684

NPI assigned

Sep 1, 2011

Organization subpart

No

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

Authorized official

Name

Carlos Meza-Valencia, C-SA

Title

Owner, President

Phone

(571) 244-4684

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Louis Kalisch, SA-C

  • Surgical Physician Assistant
  • Fairfax, VA
  • NPI 1700234325
  NPD (past)

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393027200000",
    "number": "1356622583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10332 MAIN ST # 344",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302410",
            "telephone_number": "571-244-4684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10332 MAIN ST # 344",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302410",
            "telephone_number": "571-244-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2014-02-22",
        "status": "A",
        "authorized_official_last_name": "MEZA-VALENCIA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "571-244-4684",
        "authorized_official_credential": "C-SA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2014; 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.