NPIMap

Organization Active NPI

Tri State Urologic Services PSC Inc

  • Urology Physician
  • Cincinnati, OH
National Provider Identifier
1699237909
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
TRI STATE UROLOGIC SERVICES PSC INC
Practice address
2123 Auburn Ave Ste 434
Cincinnati, OH 45219-2906
Phone
(513) 841-7474
Fax
(513) 841-7401
NPI assigned
Apr 4, 2019
Last updated
Apr 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Authorized official

Name
Earl L Walz
Title
Ceo
Phone
(513) 841-7404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

2123 Auburn Ave Ste 434
Cincinnati, OH 45219-2906

Mailing address

2000 Joseph E Sanker Blvd
Cincinnati, OH 45212-1979
Phone (513) 841-7404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000285 OH Part B Supplier - Clinic/Group Practice 6204740889 Receives reassigned benefits from 87 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilmington, OH; West Chester, OH; Oxford, OH; Middletown, OH; Hamilton, OH; Fairfield, OH; Cincinnati, OH; Blue Ash, OH

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory
Tax ID family
Tri State Urologic SVCS PSC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2123 Auburn Ave
Ste 434
Cincinnati, OH 45219
Phone (513) 621-6090

Practitioners & affiliated clinicians

Practitioners 4

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": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1699237909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 JOSEPH E SANKER BLVD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452121979",
            "telephone_number": "513-841-7404",
            "fax_number": "513-841-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 AUBURN AVE STE 434",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192906",
            "telephone_number": "513-841-7474",
            "fax_number": "513-841-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE UROLOGIC SERVICES PSC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "WALZ",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-841-7404"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 4, 2019; 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.