NPIMap

Organization Active NPI

Tri State Obstetrics & Gynecology

Doing business as Heritage Valley Generations OB/GYN

  • Obstetrics & Gynecology Physician
  • Beaver Falls, PA
National Provider Identifier
1568419281
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
TRI STATE OBSTETRICS & GYNECOLOGY
Doing business as
Heritage Valley Generations OB/GYN
Heritage Valley OB/GYN
Practice address
2580 Constitution Blvd
Beaver Falls, PA 15010-1294
Phone
(724) 843-0737
Fax
(724) 770-7922
NPI assigned
May 28, 2006
Last updated
Jul 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary
Gynecology Physician 207VG0400X
Obstetrics Physician 207VX0000X

Addresses

Primary practice location

2580 Constitution Blvd
Beaver Falls, PA 15010-1294

Mailing address

2 Peartree Way
Beaver, PA 15009-1954
Phone (724) 773-6802

Other identifiers 1

IdentifierTypeStateIssuer
0015486320010MedicaidPA

Other names 2

  • Heritage Valley Generations OB/GYN Doing business as
  • Heritage Valley OB/GYN Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211001136 PA Part B Supplier - Clinic/Group Practice 5597659334 Receives reassigned benefits from 8 practitioners
Practice locations: Beaver, PA; Beaver Falls, PA; Monaca, PA

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
39D0174916Heritage Valley Generations OB/GYN2580 Constitution Boulevard, Beaver Falls, PA 15010Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

200 Ohio River Blvd
Baden, PA 15005

195 Boundry Ln
Beaver, PA 15009
Phone (724) 775-4327

316 6th St
Ellwood City, PA 16117
Phone (724) 843-0737

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1568419281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PEARTREE WAY",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150091954",
            "telephone_number": "724-773-6802",
            "fax_number": "724-770-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 CONSTITUTION BLVD",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150101294",
            "telephone_number": "724-843-0737",
            "fax_number": "724-770-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE OBSTETRICS & GYNECOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "MITRY",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "724-773-4776"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015486320010",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Valley Generations OB/GYN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Valley OB/GYN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Valley OB/GYN",
            "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 Jul 8, 2024; 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.