NPIMap

Organization Active NPI

Knickerbocker Dialysis Inc

Doing business as Elmcare Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Elmhurst, NY
National Provider Identifier
1013642404
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
KNICKERBOCKER DIALYSIS INC
Doing business as
Elmcare Dialysis
Practice address
7921 Queens Blvd
Elmhurst, NY 11373-3746
Phone
(929) 895-7482
Fax
(929) 895-7023
NPI assigned
Jul 19, 2022
Last updated
Jul 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
DAVITA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Authorized official

Name
John Winstel
Title
Chief Accounting Officer
Phone
(615) 320-4414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

7921 Queens Blvd
Elmhurst, NY 11373-3746

Mailing address

5200 Virginia Way
L and C Dept
Brentwood, TN 37027-7569
Phone (615) 320-4414

Other names 1

  • Elmcare Dialysis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250206001870 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 9436178191 Practice locations: Elmhurst, NY

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Elmcare DialysisCCN 332860
Ownership
Profit
Certified
Mar 12, 2025
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
18

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Knickerbocker Dialysis Inc65 organizations share this tax ID, including this one
Part of
Davita Inc

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

4560 Francis Lewis Blvd
Bayside, NY 11361
Phone (718) 224-2398

1109 Rosedale Ave
Bronx, NY 10472
Phone (347) 769-7294

1820 E Tremont Ave
Bronx, NY 10460
Phone (718) 824-0245

1940 Webster Ave
Ste 100
Bronx, NY 10457
Phone (718) 299-9212

34 Marconi St
Ste 110
Bronx, NY 10461
Phone (929) 286-5280

3525 White Plains Rd
Ste A
Bronx, NY 10467
Phone (718) 652-1013

10 Snyder Ave
Brooklyn, NY 11226
Phone (718) 282-9570

1408 Ocean Ave
Fl 2
Brooklyn, NY 11230
Phone (718) 677-7600

1601 Kings Hwy
Fl 5
Brooklyn, NY 11229
Phone (718) 645-1615

2064 Atlantic Ave
Brooklyn, NY 11233
Phone (718) 346-0475

54 New Lots Ave
Brooklyn, NY 11212
Phone (718) 345-7310

550 Kingston Ave
Brooklyn, NY 11203
Phone (718) 221-5342

2050 E Main St
Ste 15
Cortlandt Mnr, NY 10567
Phone (914) 788-9326

860 Grand Blvd
Deer Park, NY 11729
Phone (631) 243-7770

445 W Commercial St
East Rochester, NY 14445
Phone (585) 218-0517

7921 Queens Blvd
Elmhurst, NY 11373
Phone (929) 895-7482

8000 Cooper Ave
Glendale, NY 11385
Phone (718) 326-2789

9130 Van Wyck Expy
Jamaica, NY 11418
Phone (929) 421-4620

100 Crystal Run Rd
Ste 102
Middletown, NY 10941
Phone (845) 692-8220

139 Forestburgh Rd
Monticello, NY 12701
Phone (845) 791-1624

2406 Amsterdam Ave
New York, NY 10033
Phone (212) 348-5650

3801 Taylor Rd
Orchard Park, NY 14127
Phone (716) 209-0105

999 E Ridge Rd
Ste 11
Rochester, NY 14621
Phone (585) 266-7348

955 Yonkers Ave
Ste 201
Yonkers, NY 10704
Phone (914) 237-5592

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1013642404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L AND C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4414",
            "fax_number": "866-865-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7921 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733746",
            "telephone_number": "929-895-7482",
            "fax_number": "929-895-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNICKERBOCKER DIALYSIS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "615-320-4414"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elmcare Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.