Ira S Tisch, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

1576065 Issued in NY

Practice address

555 French Rd
Suite 103
New Hartford, NY 13413-1044

Phone

(315) 735-3541

Fax

(315) 724-3255

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Ira Tisch Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1629022967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 FRENCH RD",
            "address_2": "SUITE 103",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131044",
            "telephone_number": "315-735-3541",
            "fax_number": "315-724-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 FRENCH RD",
            "address_2": "SUITE 103",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131044",
            "telephone_number": "315-735-3541",
            "fax_number": "315-724-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISCH",
        "first_name": "IRA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "1576065",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1576065",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01748907",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRA",
            "last_name": "TISCH",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tarnbir Thind, OD
• Amela Thompson
• Anne Julia Thomson, RPA-C
• Tiffany Sreca, D.M.D., P.C.
• Valeria Denisse Tirado Berrios
• Vivian F Tom, M.D.
• Lynn Tomaino, LCSW
• George K Tomy, M.D.
• Maura Ann Tormey, M.S., CCC-SLP
• Gabriela Cristina Torres Rullan, DMD

• Nephrology Physician in New Hartford, NY
• Providers in New Hartford, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; 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.