TRISTATE PAIN INSTITUTE
NPI 1649598426
Pain Medicine - Pain Medicine in Fort Mohave, AZ
About Tristate Pain Institute NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TRISTATE PAIN INSTITUTE (NPI 1649598426) is a healthcare organization registered as a pain medicine in Fort Mohave, Arizona and active in the NPI registry since May 2010. The organization lists Knaya Tabora, Owner/member Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 8
Other Names 1
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tristate Pain Institute is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
14Medicare enrollment records show 14 clinicians reassign Medicare billing to Tristate Pain Institute, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (14)
Fort Mohave, AZ 86426
Las Vegas, NV 89121
Santa Fe, NM 87507
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Medical Specialists LLC's NPI number?
The NPI number for Tri-State Medical Specialists LLC is 1649598426. It was assigned to this organization in the NPPES registry on May 4, 2010. The provider is doing business as Tristate Pain Institute.
Where is Tri-State Medical Specialists LLC located?
Tri-State Medical Specialists LLC is located at 1510 E Wagon Wheel Ln Ste 110, Fort Mohave, AZ 86426. The listed phone number is (928) 788-3333.
What is Tri-State Medical Specialists LLC's specialty?
The primary specialty registered for this NPI is Pain Medicine with taxonomy code 208VP0000X.
Is Tri-State Medical Specialists LLC enrolled in Medicare?
Yes. Tri-State Medical Specialists LLC is registered in the Medicare PECOS enrollment system.
When is Tri-State Medical Specialists LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Nevada, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Tri-State Medical Specialists LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians in 5 Medicare specialties reassign their Medicare billing to Tri-State Medical Specialists 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 Nurse Practitioner (5), Pain Management (4) and Family Practice (2). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Tri-State Medical Specialists LLC accept?
Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Tri-State Medical Specialists LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Tri-State Medical Specialists LLC was last updated on October 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Tristate Pain Institute · NPI 1649598426
Pain Medicine organization in Fort Mohave, Arizona. Organization record, active in the CMS NPPES registry since May 4, 2010.
## Identity
- **NPI:** 1649598426 (Entity type: Organization)
- **Enumerated:** May 4, 2010
- **Primary specialty:** Pain Medicine - Pain Medicine · taxonomy 208VP0000X
- **Legal business name:** Tri-State Medical Specialists Llc
- **Organization subpart:** No
- **Authorized official:** Knaya Tabora, OWNER/MEMBER MANAGER
## Practice location
- **Address:** 1510 E WAGON WHEEL LN STE 110, Fort Mohave, AZ 86426-6698
- **Phone:** (928) 788-3333 · **Fax:** (928) 788-3555
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Nevada, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 14 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Pain Management (4), Family Practice (2); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 12, 2023
- **Other identifiers:** Medicaid 527366 (AZ); Other DQ4807 (AZ)
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Source: [NPI Profile](https://npiprofile.com/npi/1649598426) · Data from the CMS NPPES public registry.