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NPI Code Detail

MEDICARE: TRI STATE UROLOGIC SERVICES PSC INC

MEDICARE: TRI STATE UROLOGIC SERVICES PSC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2363LA2100XAcute Care Nurse Practitioner
3363LF0000XFamily Nurse Practitioner
4363AM0700XMedical Physician Assistant
5367500000XCertified Registered Nurse Anesthetist
6332900000XNon-Pharmacy Dispensing Site26192KY
7208800000XUrology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12158101OTHERPK

General Provider Information

NPI Number : 1275726580
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRI STATE UROLOGIC SERVICES PSC INC
Provider Business Mailing Address
First Line : 2000 JOSEPH SANKER BLVD
Second Line :
City : CINCINNATI
State : OH
Zip : 45212-1979
Country : US
Telephone Number : 513-841-7400
Fax Number : 513-841-7402
Provider Business Practice Location Address
First Line : 350 THOMAS MORE PKWY STE 200
Second Line :
City : CRESTVIEW HILLS
State : KY
Zip : 41017-5460
Country : US
Telephone Number : 859-363-2200
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : DANIEL SCHRAFF
Credential :
Telephone Number : 614-339-3998
Provider Enumeration Date : 08/20/2007
Last Update Date : 03/09/2026

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