NPIMap

Organization Active NPI

Tri-State Pain Management Service Inc

  • Interventional Pain Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1407028269
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
TRI-STATE PAIN MANAGEMENT SERVICE INC
Practice address
7500 State Rd
Mercy Anderson Hospital
Cincinnati, OH 45255-2439
Phone
(859) 341-7246
Fax
(859) 341-7867
NPI assigned
Apr 1, 2008
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Sairam L Atluri, MD
Title
President Owner
Phone
(859) 341-7246

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Interventional Pain Medicine Physician 208VP0014X NU Primary

Addresses

Primary practice location

7500 State Rd
Mercy Anderson Hospital
Cincinnati, OH 45255-2439

Mailing address

L-6067
Cincinnati, OH 45270-6067
Phone (859) 341-7246

Other identifiers 6

IdentifierTypeStateIssuer
200529320AMedicaidIN
65944233MedicaidKY
2044773MedicaidOH
5124498OtherCIGNA
728014OtherBUCKEYE
610168000OtherFEDERAL WORKERS COMP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000793 OH Part B Supplier - Clinic/Group Practice 2163415829 Receives reassigned benefits from 3 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cincinnati, OH

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1407028269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "L-6067",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452706067",
            "telephone_number": "859-341-7246",
            "fax_number": "859-341-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 STATE RD",
            "address_2": "MERCY ANDERSON HOSPITAL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452552439",
            "telephone_number": "859-341-7246",
            "fax_number": "859-341-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE PAIN MANAGEMENT SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "ATLURI",
        "authorized_official_first_name": "SAIRAM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "859-341-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200529320A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65944233",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2044773",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5124498",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "728014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORKERS COMP",
            "identifier": "610168000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.