Southern Westchester Nephrology PLLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

168949 Issued in NY

Legal business name

SOUTHERN WESTCHESTER NEPHROLOGY PLLC

Practice address

136 S Broadway
Yonkers, NY 10701-4008

Phone

(914) 965-0621

NPI assigned

Feb 23, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Dominick Frank Reda, M.D.NPI 1033296439

Title

Owner

Phone

(914) 965-0621

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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 11

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

• Dominick F. Reda, M.D.

  • Nephrology Physician
  • Yonkers, NY
  • NPI 1033296439
  Medicare reassignment Care Compare group NPD Authorized official
• Majed Mark Samarneh, MD

  • Internal Medicine Physician
  • Yonkers, NY
  • NPI 1366687139
  Medicare reassignment Care Compare group NPD
• Mauricio Valdes, M.D.

  • Nephrology Physician
  • Yonkers, NY
  • NPI 1215017769
  Medicare reassignment Care Compare group NPD
• Jeya Balasubramanian, PA

  • Medical Physician Assistant
  • Bronx, NY
  • NPI 1902931785
  NPD (past)
• Bobbie Eapen, P.A.

  • Physician Assistant
  • Syosset, NY
  • NPI 1326338153
  NPD (past)
• Barbara Hoffman, PA-C

  • Medical Physician Assistant
  • Bronx, NY
  • NPI 1275024952
  NPD (past)
• Ivannette Juarbe-Ramos, M. D.

  • Family Medicine Physician
  • Bronx, NY
  • NPI 1083929525
  NPD (past)
• Ruby Mathew

  • Adult Health Nurse Practitioner
  • New York, NY
  • NPI 1407265580
  NPD (past)
• Robert Samaniego, M.D

  • Family Medicine Physician
  • Rye, NY
  • NPI 1083632392
  NPD (past)
• Raul Alberto Ulloa, M.D.

  • Family Medicine Physician
  • Valhalla, NY
  • NPI 1841330107
  NPD (past)
• Jean-Carlos Jimenez, M.D.

  • Hospitalist Physician
  • Sharon, CT
  • NPI 1801154455
  NPD (past)

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605744000000",
    "number": "1033416342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PARKFIELD RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107014008",
            "telephone_number": "914-965-0621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1088 N Broadway Fl 2",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "10701",
            "country_code": "US",
            "telephone_number": "914-965-0621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN WESTCHESTER NEPHROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-23",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "REDA",
        "authorized_official_first_name": "DOMINICK",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-965-0621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "168949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Boulevard Medical Care PC
• Southern Westchester Diagnostic Imaging
• Southern Westchester Family Medicine, P.C.
• Southern Westchester Infectious Disease Group, PLLC
• Southern Westchester Medical PC
• Southern Westchester OB/GYN Associates, LLP
• Southern Westchester Orthopedics & Sports Medicine Assoc. P.C.
• Southern Westchester Urgent Care PLLC
• Southern Westchester Urology PLLC
• Ganiyat Temitope Sowunmi, PHARMD

• Nephrology Physician in Yonkers, NY
• Providers in Yonkers, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.