Tri State Medical Assoc. P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OSOO4513LL Issued in PA

Legal business name

TRI STATE MEDICAL ASSOC. P.C.

Practice address

906 Pennsylvania Ave
Matamoras, PA 18336-1542

Phone

(579) 491-4164

Fax

(570) 491-5186

NPI assigned

Jul 4, 2006

Last updated

Jan 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey C Auerbach, D.O.NPI 1720037583

Title

Treasurer

Phone

(579) 491-4164

Specialties & licenses 1

Addresses

Other identifiers 6

Practitioners 2

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.

• Jeffrey C Auerbach, D.O.

  • Internal Medicine Physician
  • Matamoras, PA
  • NPI 1720037583
  NPD (past) Authorized official
• Mehjabeen Alam, M.D.

  • Internal Medicine Physician
  • Matamoras, PA
  • NPI 1417906744
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1679503726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 PENNSYLVANIA AVE",
            "city": "MATAMORAS",
            "state": "PA",
            "postal_code": "183361542",
            "telephone_number": "579-491-4164",
            "fax_number": "570-491-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 PENNSYLVANIA AVE",
            "city": "MATAMORAS",
            "state": "PA",
            "postal_code": "183361542",
            "telephone_number": "579-491-4164",
            "fax_number": "570-491-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE MEDICAL ASSOC. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "AUERBACH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "579-491-4164",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OSOO4513LL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE",
            "identifier": "0064202000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY",
            "identifier": "165007",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTHCARE",
            "identifier": "117236",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7001046",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CD3145",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "37785",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Q Rhodes, PHARMD
• Samantha Lin Sanchez
• Cristina M Seidel, RPH
• Micah Patrick Sweeney, LCSW
• Lisa Margaret Toaldo, DMD
• Ian Alexander Trujillo, BCBA, LBA
• Christine Ann Wasko, RPH
• Westfall Township Volunteer Fire Department
• Laura Wolfe, PHARM D
• Diana S Young

• Internal Medicine Physician in Matamoras, PA
• Providers in Matamoras, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.