Tricity Riverside Dialysis

Primary specialty

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

Legal business name

TRICITY RIVERSIDE DIALYSIS

Practice address

7275 Indiana Ave
Riverside, CA 92504-4543

Phone

(951) 343-1978

NPI assigned

Aug 14, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Mohammed Qutub Khan, MDNPI 1912008087

Title

President

Phone

(951) 343-1978

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Tricity Riverside DialysisCCN 552899

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Mar 23, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

22

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammed Q Khan, M.D.

  • Specialist
  • Riverside, CA
  • NPI 1912008087
  NPD (past) Authorized official

Affiliated clinicians 1

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

• Mohammed Q Khan, M.D.

  • Specialist
  • Riverside, CA
  • NPI 1912008087

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553472000000",
    "number": "1003396615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3595 VAN BUREN BLVD STE 203",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925030311",
            "telephone_number": "951-343-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7275 INDIANA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925044543",
            "telephone_number": "951-343-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICITY RIVERSIDE DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2019-03-25",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "QUTUB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-343-1978",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Trejo
• Sasha Brigett Trejos, LCSW
• Amy L Tresky
• Veronica Trevino
• Jana Trew
• Aizzel Ramas Trieu, NP
• Noelle M Trigerous, LMFT
• Susana Georgina Trigo
• Jocelyn Sydney Trigotenco Ceron
• Darius Julian Trimble

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Riverside, CA
• Providers in Riverside, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.