TRI-STATE MEDICAL GROUP, INC. (NPI# 1326275595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326275595 |
| Entity Type | Organization |
| Organization Name | TRI-STATE MEDICAL GROUP, INC. |
| Practice Address |
Route 18 Wal-mart Shopping Plaza Heritage Valley Convenient Care-monaca Monaca PA 15061 |
| Mailing Address |
1000 Dutch Ridge Road Heritage Valley Beaver Credentialing C-4 Beaver PA 15009 |
| Practice Telephone | 7247745175 |
| Practice Fax Number | 7247745175 |
| Mailing Telephone | 7247734776 |
| Mailing Fax Number | 7247734726 |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2009-06-16 |
| Authorized Official Name | NORMAN F. MITRY (PRESIDENT & CEO) |
| Authorized Official Telephone | 7247734776 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0014950830029 | 05 | |
| PA | 1007289980010 | 05 | |
| PA | 0015654460023 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790019438 | Tri-state Medical Group, Inc. | Physical Medicine & Rehabilitation | 1030 Beaner Hollow Road, Beaver Medical Commons, Beaver, PA 15009 | 2009-09-29 |
| 1215164488 | Tri-state Medical Group, Inc. | Internal Medicine | 100 Chippewa Town Ctr., Heritage Valley Convenient Care-beaver Falls, Beaver Falls, PA 15010 | 2009-06-16 |
| 1437435161 | Tri-state Medical Group, Inc. | Family Medicine | 3468 Brodhead Rd, Monaca, PA 15061-3149 | 2011-10-26 |
| 1619116738 | Tri-state Medical Group, Inc. | Family Medicine | 2620 Constitution Blvd, Lower Level, Beaver Falls, PA 15010-1278 | 2009-02-12 |
| 1679725279 | Tri-state Medical Group, Inc. | Family Medicine | 3950 Brodhead Rd, Suite 200, Monaca, PA 15061-3030 | 2008-10-15 |
| 1275785057 | Tri-state Medical Group, Inc. | Internal Medicine | 99 Autumn St, Suite 101, Aliquippa, PA 15001-1301 | 2008-10-13 |
| 1437301280 | Tri-state Medical Group, Inc. | Internal Medicine | 1307 6th Ave, Beaver Falls, PA 15010-4213 | 2008-10-10 |
| 1871745620 | Tri-state Medical Group, Inc. | Physical Medicine & Rehabilitation | 5000 Industrial Blvd, Aliquippa, PA 15001-4874 | 2008-10-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | TRI-STATE MEDICAL GROUP, INC. | 1600 Morgan Street, Keokuk, IA 52632 |
| Street Address |
ROUTE 18 WAL-MART SHOPPING PLAZA HERITAGE VALLEY CONVENIENT CARE-MONACA |
| City | MONACA |
| State | PA |
| Zip Code | 15061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124498910 | Ashley Lynn Bell | Physician Assistant | 3944 Brodhead Road, Suite 7b, Monaca, PA 15061 | 2015-10-06 |
| 1902193105 | Robert Martin Niedermeyer Jr. | Pharmacist | 87 Wagner Road, Monaca, PA 15061 | 2011-07-08 |
| 1033416979 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 118 Wagner Rd, Monaca, PA 15061 | 2011-02-11 |
| 1053560888 | Beth Ann Klump | Physician Assistant | 3572 Brodhead Rd., Suite 301, Monaca, PA 15061 | 2008-09-17 |
| 1376687954 | Luke E Stall | Radiology | 3582 Brodhead Rd Ste 204, Monaca, PA 15061 | 2007-02-16 |
| 1063595684 | Wal-mart Stores East, Lp | Technician/Technologist | Pa. Rt.18/wal-mart Plaza Shpg., Monaca, PA 15061 | 2006-10-24 |
| 1366533945 | Regine Lydie Bataille-gossard | Optometrist | Walmart Vision Center, Walmart Plaza Route 18, Monaca, PA 15061 | 2006-09-27 |
| 1346341708 | Richa Bajaj | Dentist | 125 Wagner Rd, Monaca, PA 15061 | 2006-09-26 |
| 1538265319 | David Walter Jaskiewicz | Optometrist | Route 18, Walmart Plaza, Monaga, PA 15061 | 2006-09-16 |
| 1275636011 | Pennsylvania Cvs Pharmacy LLC | Pharmacy | 850 Pennsylvania Ave, Monaca, PA 15061 | 2006-09-07 |
| Find all providers in zip 15061 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497028054 | Medexpress Urgent Care, PC - Pennsylvania | Family Medicine | 3944 Brodhead Rd, Suite 7b, Monaca, PA 15061-3029 | 2012-02-13 |
| 1437435161 | Tri-state Medical Group, Inc. | Family Medicine | 3468 Brodhead Rd, Monaca, PA 15061-3149 | 2011-10-26 |
| 1679725279 | Tri-state Medical Group, Inc. | Family Medicine | 3950 Brodhead Rd, Suite 200, Monaca, PA 15061-3030 | 2008-10-15 |
| 1972529725 | Matthew Britt Coombs | Family Medicine | 3950 Brodhead Rd, Suite 200, Monaca, PA 15061-3030 | 2006-07-14 |
| 1558387308 | Gregg S Zernich | Family Medicine | 3950 Brodhead Rd, Suite 200, Monaca, PA 15061-3030 | 2006-07-14 |
| 1902860026 | S L Wilcox Health Services | Family Medicine | 3428 Brodhead Rd, Monaca, PA 15061-3132 | 2006-04-14 |
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| 1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
| 1649882275 | Blair Regenerative Medicine LLC | Family Medicine | 201 Hospital Dr Ste 2, Everett, PA 15537-7019 | 2020-08-17 |
| 1447861521 | Mature Resources Foundation | Family Medicine | 28944 Frenchville Karthaus Hwy, Frenchville, PA 16836-8834 | 2020-08-12 |
| 1619587227 | Cmp Medical LLC | Family Medicine | 3626 Sears St, Philadelphia, PA 19146-3217 | 2020-08-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.