NPIMap

Organization Active NPI

Tri-State Medical Group, Inc

Doing business as Heritage Valley Stephen Hagberg MD

  • Family Medicine Physician
  • Beaver Falls, PA
National Provider Identifier
1396076881
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD437163 Issued in PA
Legal business name
TRI-STATE MEDICAL GROUP, INC
Doing business as
Heritage Valley Stephen Hagberg MD
Practice address
918 3Rd Ave
Beaver Falls, PA 15010-4613
Phone
(724) 773-8895
Fax
(724) 770-7945
NPI assigned
Jan 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Authorized official

Name
Norman F. Mitry
Title
President & Ceo
Phone
(724) 773-4776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD437163 PA Primary

Addresses

Primary practice location

918 3Rd Ave
Beaver Falls, PA 15010-4613

Mailing address

918 3Rd Ave
Beaver Falls, PA 15010-4613
Phone (724) 773-8895

Other identifiers 1

IdentifierTypeStateIssuer
0015654460023MedicaidPA

Other names 1

  • Heritage Valley Stephen Hagberg MD Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tri - State Medical Group Inc92 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264118400000",
    "number": "1396076881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 3RD AVE",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150104613",
            "telephone_number": "724-773-8895",
            "fax_number": "724-770-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 3RD AVE",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150104613",
            "telephone_number": "724-773-8895",
            "fax_number": "724-770-7945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A",
        "authorized_official_last_name": "MITRY",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "724-773-4776"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD437163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015654460023",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Valley Stephen Hagberg MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaver Falls, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.