NPIMap

Organization Active NPI

Washington Dialysis Clinic, Inc.

  • Nephrology Physician
  • Washington, PA
National Provider Identifier
1023294469
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD035880L Issued in PA
Legal business name
WASHINGTON DIALYSIS CLINIC, INC.
Practice address
764 Locust Ave
Washington, PA 15301-2756
Phone
(724) 229-7377
Fax
(724) 228-1513
NPI assigned
Jan 16, 2008
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Subramoniam Jayakumar, MD
Title
Owner, C.E.O
Phone
(724) 229-7377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD035880L PA Primary

Addresses

Primary practice location

764 Locust Ave
Washington, PA 15301-2756

Mailing address

764 Locust Ave
Washington, PA 15301-2756
Phone (724) 229-7377

Other identifiers 2

IdentifierTypeStateIssuer
MD035880LOtherPAMEDICAL LICENSE
127527MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1023294469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 LOCUST AVE",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153012756",
            "telephone_number": "724-229-7377",
            "fax_number": "724-228-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 LOCUST AVE",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153012756",
            "telephone_number": "724-229-7377",
            "fax_number": "724-228-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON DIALYSIS CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "JAYAKUMAR",
        "authorized_official_first_name": "SUBRAMONIAM",
        "authorized_official_title_or_position": "OWNER, C.E.O",
        "authorized_official_telephone_number": "724-229-7377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD035880L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD035880L",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127527",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.