NPIMap

Organization Active NPI

Tri-State Medical Group, Inc

  • Family Medicine Physician
  • Cranberry TWP, PA
National Provider Identifier
1841429099
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRI-STATE MEDICAL GROUP, INC
Practice address
1185 Freedom Rd
Suite B106
Cranberry TWP, PA 16066-4913
Phone
(724) 777-3596
NPI assigned
Jul 9, 2009
Last updated
Jul 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1185 Freedom Rd
Suite B106
Cranberry TWP, PA 16066-4913

Mailing address

1185 Freedom Rd
Suite B106
Cranberry TWP, PA 16066-4913
Phone (724) 773-5964

Other identifiers 2

IdentifierTypeStateIssuer
0202677MedicaidOH
0015654460023MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Heritage Valleymedical Group Inc92 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Locations

1185 Freedom Rd
Ste B106
Cranberry Twp, PA 16066
Phone (724) 777-3596

NPI Registry JSON

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247097600000",
    "number": "1841429099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 FREEDOM RD",
            "address_2": "SUITE B106",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160664913",
            "telephone_number": "724-773-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 FREEDOM RD",
            "address_2": "SUITE B106",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160664913",
            "telephone_number": "724-777-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-09",
        "last_updated": "2009-07-09",
        "status": "A",
        "authorized_official_last_name": "MITRY",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "724-773-4776"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0202677",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015654460023",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranberry TWP, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.