Mount Vernon Dialysis LLC

Primary specialty

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

Legal business name

MOUNT VERNON DIALYSIS LLC

Practice address

12 N 7TH Avenue
3Rd Floor
Mount Vernon, NY 10550-2026

Phone

(914) 665-4343

Fax

(914) 665-2982

NPI assigned

Aug 1, 2007

Organization subpart

No

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

Authorized official

Name

Christopher Obhokhan Adubor, MD

Title

Medical Director

Phone

(914) 665-4343

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Listed as

Mount Vernon Dialysis,LLCCCN 332661

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Oct 8, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

24

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

Affiliated clinicians 3

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

• Christopher Obhokhan Adubor, MD

  • Nephrology Physician
  • Mount Vernon, NY
  • NPI 1962464594

  Dialysis facility

  Care Compare affiliation Name & address match
• Kameswari Desiraju Lakshmi, MD

  • Nephrology Physician
  • New Rochelle, NY
  • NPI 1942324132

  Dialysis facility

  Care Compare affiliation Name & address match
• Muhammad Irfan Qadir, M.D.

  • Nephrology Physician
  • Mount Vernon, NY
  • NPI 1154416071

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1013107358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 N 7TH AVE",
            "address_2": "3RD FLOOR",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502026",
            "telephone_number": "914-665-4343",
            "fax_number": "914-665-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N 7TH AVENUE",
            "address_2": "3RD FLOOR",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502026",
            "telephone_number": "914-665-4343",
            "fax_number": "914-665-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT VERNON DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "ADUBOR",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "OBHOKHAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "914-665-4343",
        "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": []
}

• Diana Frances Morse, MD
• Zoe Morse
• Adele Moulton, LPN
• Mount Vernon Adult Center LLC
• Mount Vernon City School District
• Mount Vernon Eye Care
• Mount Vernon Hospital
• Mount Vernon Hospital
• Mount Vernon Hospital Department of Medicine
• Mount Vernon Hospital Radiology Associates, P.C.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Mount Vernon, NY
• Providers in Mount Vernon, 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 Nov 11, 2008; 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.