TRI-STATE MEDICAL SPECIALISTS LLC
TRI-STATE MEDICAL SPECIALISTS LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1649598426, based in Fort Mohave, AZ. The organization lists 8 taxonomy classifications, with Pain Medicine Physician recorded as primary.
Getting there
The practice address on file is 1510 E WAGON WHEEL LN STE 110, Fort Mohave, AZ 86426. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 20605 | AZ | Neurological Surgery Physician |
| 5573 | NY | Neurological Surgery Physician |
| 20605 | AZ | Pain Medicine Physician |
| 5573 | NV | Pain Medicine Physician |
| AP8599 | AZ | Nurse Practitioner |
| AP3760 | AZ | Nurse Practitioner |
| AP8599 | AZ | Family Nurse Practitioner |
| AP8599 | AZ | Primary Care Nurse Practitioner |
Licences are recorded in 3 states: AZ, NY, NV. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 1850422023
Enrolled in Medicare 4 times, across 3 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Arizona | O20100702000024 | Part B Supplier - Clinic/group Practice |
| Arizona | O20110630000633 | Dme Supplier - Physician - General Practice |
| Nevada | O20111011000229 | Part B Supplier - Clinic/group Practice |
| California | O20140630000650 | Part B Supplier - Clinic/group Practice |
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. There are 4 separate enrolment records across 3 states (AZ, NV, CA). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 3 states
This provider holds licences in 3 states: Arizona, Nevada and New York. The practice address on file is in Fort Mohave, AZ, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- 20605
- Specialty
- Neurological Surgery Physician
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Pain Medicine covers
Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies. NUCC Health Care Provider Taxonomy, code 208VP0000X
All registered taxonomy codes
This provider registers 12 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 208VP0000X | Pain Medicine Physician Pain Medicine | — | — | primary |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician Pain Medicine | — | — | |
| 207T00000X | Neurological Surgery Physician | 20605 | AZ | |
| 207T00000X | Neurological Surgery Physician | 5573 | NY | |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician Pain Medicine | — | — | |
| 208VP0000X | Pain Medicine Physician Pain Medicine | 20605 | AZ | |
| 208VP0000X | Pain Medicine Physician Pain Medicine | 5573 | NV | |
| 208VP0014X | Interventional Pain Medicine Physician Interventional Pain Medicine | — | — | |
| 363L00000X | Nurse Practitioner | AP8599 | AZ | |
| 363L00000X | Nurse Practitioner | AP3760 | AZ | |
| 363LF0000X | Family Nurse Practitioner Family | AP8599 | AZ | |
| 363LP2300X | Primary Care Nurse Practitioner Primary Care | AP8599 | AZ |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1649598426 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | May 4, 2010 |
| Last updated | Oct 12, 2023 |
| Status | Active |
| Practice address |
1510 E WAGON WHEEL LN STE 110 Fort Mohave, AZ 86426 (928) 788-3333 Fax (928) 788-3555 |
| Other identifiers |
527366
· Medicaid (AZ) DQ4807 · Other (AZ) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 6 | 4 | 9 | 5 | 9 | 8 | 4 | 2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 6 | 8 | 9 | 1 | 9 | 7 | 4 | 4 |
Sum = 74 · next multiple of 10 = 80 · check digit = 6 · actual last digit = 6
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.