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TRI-STATE SURGICAL CENTER, LLC
NPI 1053939074
Anesthesiology in Martinsburg, WV

Active since July 07, 2020CLIA 51D1018379 · Waiver
1006 TAVERN RD, MARTINSBURG, WV 25401(304) 267-0556(304) 267-1460 Get Directions Write a Review

NPPES record last updated: July 9, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Tri-state Surgical Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRI-STATE SURGICAL CENTER, LLC (NPI 1053939074) is a healthcare organization registered as an anesthesiology in Martinsburg, West Virginia and active in the NPI registry since July 2020. The organization holds a CLIA Waiver certificate valid through October 20, 2027 and lists Hilda Lynn Hoffmaster, Billing/coding Manager, as its authorized official.

NPPES Registry Identity

NPI1053939074
Entity TypeOrganization
Primary Taxonomy207L00000X
Legal Business NameTRI-STATE SURGICAL CENTER, LLC
Location Address1006 TAVERN RDMartinsburg, WV 25401-2864
Mailing Address1006 Tavern RdMartinsburg, WV 25401-2864 · (304) 267-0556 · Fax (304) 267-1460
Phone(304) 267-0556
Fax(304) 267-1460
Organization SubpartYes
Authorized OfficialHilda Lynn HoffmasterBilling/coding Manager · (304) 263-5129
Enumeration DateJuly 7, 2020
Last NPPES UpdateJuly 9, 2020
NPPES CertifiedJuly 9, 2020
✔ NPI 1053939074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
1006 TAVERN RD, Martinsburg, WV 25401
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Other Identifiers 1

Medicaid6905041000WV

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tri-state Surgical Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Tri-State Surgical Center, LLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Duong Ly, MD
Anesthesiology
NPI 1124032917
1006 TAVERN RD
Martinsburg, WV 25401
(304) 267-5141
✔ PECOSSame address
Thomas Downey, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1750377263
1006 TAVERN RD
Martinsburg, WV 25401
(304) 267-5141
Same address
Mercedes Dockeney, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1457476624
1006 TAVERN RD
Martinsburg, WV 25401
(304) 267-0556
✔ Accepts MedicareSame address
John Erwin, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1386980969
1006 TAVERN RD
Martinsburg, WV 25401
(304) 267-0556
✔ Accepts MedicareSame address
Lindsey Evers, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1518323070
1006 TAVERN RD
Martinsburg, WV 25401
(304) 267-0556
✔ Accepts MedicareSame address
Gregory Cresswell, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1710547187
2500 HOSPITAL DR
Martinsburg, WV 25401
(304) 264-1000
✔ Accepts Medicare0.5 mi
Kelli Jones, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1760988950
11116 MEDICAL CENTER
Hagerstown, MD 21742
(301) 790-8000
✔ Accepts Medicare18 mi
Debra Clise, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1437130465
6900 GEORGIA AVE NW
Washington, DC 20307
(202) 782-7748
61 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 51D1018379

Tri State Surgical Center · Martinsburg, WV
Active · expires Oct 20, 2027
CLIA Number51D1018379
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateOctober 21, 2025
Certificate Expiration DateOctober 20, 2027
Laboratory DirectorTroy D. Foster Do
Laboratory Phone(304) 263-5129
Laboratory LocationTri State Surgical Center1006 Tavern Road, Martinsburg, WV 25401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tri-State Surgical Center, LLC's NPI number?

The NPI number for Tri-State Surgical Center, LLC is 1053939074. It was assigned to this organization in the NPPES registry on July 7, 2020.

Where is Tri-State Surgical Center, LLC located?

Tri-State Surgical Center, LLC is located at 1006 Tavern Rd, Martinsburg, WV 25401. The listed phone number is (304) 267-0556.

What is Tri-State Surgical Center, LLC's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Tri-State Surgical Center, LLC enrolled in Medicare?

Yes. Tri-State Surgical Center, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tri-State Surgical Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 2 Medicare specialties reassign their Medicare billing to Tri-State Surgical Center, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Certified Registered Nurse Anesthetist (CRNA) (7) and Anesthesiology (1). Of these, 5 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Tri-State Surgical Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 51D1018379) is associated with this NPI, valid through October 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tri-State Surgical Center, LLC was last updated on July 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.