Vestal Healthcare, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

VESTAL HEALTHCARE, LLC

Practice address

52 S Union Rd
Williamsville, NY 14221-6555

Phone

(716) 630-6831

Fax

(716) 630-6838

NPI assigned

Jan 28, 2014

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Barry L. Blanton

Title

Vice President

Phone

(781) 699-9000

Specialties & licenses 1

Addresses

Other names 1

• FREEDOM CENTER OF BUFFALO Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Vestal Healthcare, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Vestal, NY
  • NPI 1124063698

  9335152693

  Same PAC ID
• Vestal Healthcare, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Wappingers Falls, NY
  • NPI 1174188338

  9335152693

  Same PAC ID
• Vestal Healthcare, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Binghamton, NY
  • NPI 1487969671

  9335152693

  Same PAC ID

Listed as

FMS-Freedom Center of BuffaloCCN 332713

Ownership

Profit

Certified

Jun 26, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Fresenius Medical Care

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Richard T Jenkins, M.D.

  • Nephrology Physician
  • Lewiston, NY
  • NPI 1164840369

  Dialysis facility

  Care Compare affiliation Name & address match
• Prashant Pendyala, MD

  • Nephrology Physician
  • Lockport, NY
  • NPI 1801842844

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1003239062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 S UNION RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216555",
            "telephone_number": "716-630-6831",
            "fax_number": "716-630-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 S UNION RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216555",
            "telephone_number": "716-630-6831",
            "fax_number": "716-630-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VESTAL HEALTHCARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2014-01-28",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "BLANTON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "FREEDOM CENTER OF BUFFALO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karim Velji, M.D.
• Arlen Odalina Ventura Camilo, MD
• Ann Venuto, NP
• Sherry Ann Verostko-Slazak
• Jordan Rae Verrall, FNP
• Eric E Vetter, DDS
• Marissa Vice, LPN
• Vikas K Pilly MD PC
• Village Dental Acquisition, PLLC
• Brittany A Vincent

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Williamsville, NY
• Providers in Williamsville, NY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.