Organization Active NPI

Tri-State Neurosurgical PC

  • Specialist
  • Newburgh, IN
National Provider Identifier
1629831714
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
TRI-STATE NEUROSURGICAL PC
Practice address
4133 Gateway Blvd Ste 170
Newburgh, IN 47630-8950
Phone
(812) 758-4199
NPI assigned
Feb 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Authorized official

Name
David Eggers, MDNPI 1518960483
Title
Owner
Phone
(812) 758-4199

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

4133 Gateway Blvd Ste 170
Newburgh, IN 47630-8950

Mailing address

PO Box 1642
Evansville, IN 47706-0043
Phone (812) 758-4199

Other practice location 1

2780 Frederica St
Owensboro, KY 42301-5442
Phone (270) 344-5201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240308002884 KY Part B Supplier - Clinic/Group Practice 1951747260 Receives reassigned benefits from 3 practitioners
Practice locations: Owensboro, KY
O20240328001662 IN Part B Supplier - Clinic/Group Practice 1951747260 Receives reassigned benefits from 3 practitioners
Practice locations: Newburgh, IN

National Provider Directory

National Provider Directory

Locations

2780 Frederica St
Owensboro, KY 42301
Phone (270) 926-4100

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1629831714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1642",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477060043",
            "telephone_number": "812-758-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4133 GATEWAY BLVD STE 170",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308950",
            "telephone_number": "812-758-4199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2780 Frederica St",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423015442",
            "country_code": "US",
            "telephone_number": "270-344-5201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRI-STATE NEUROSURGICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-01",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "EGGERS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-758-4199",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.