Keystone Kidney Associates, PC

Primary specialty

Lithotripsy Clinic/CenterTaxonomy code 261QL0400X

Legal business name

KEYSTONE KIDNEY ASSOCIATES, PC

Practice address

359 Nina Way
Warminster, PA 18974-2826

Phone

(847) 544-5880

Fax

(512) 872-5105

NPI assigned

Sep 15, 2006

Last updated

May 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Patricia Sablesak

Title

Clinical Director

Phone

(847) 544-5880

Specialties & licenses 4

Addresses

Listed as

Keystone Kidney Associates PCCCN 39C0001278

Medicare certification status

Terminated Voluntary: merger or closure, Oct 18, 2024From the Provider of Services file

Practitioners 14

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.

• Argil J Wheelock, MD

  • Urology Physician
  • Chattanooga, TN
  • NPI 1700811346
  NPD
• Renuka Bankulla, M.D.

  • Anesthesiology Physician
  • Piermont, NY
  • NPI 1205819869
  NPD (past)
• Raquel M Benros, DO

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1033294426
  NPD (past)
• Antoinette Berkeley-Gsegnet, MD

  • Urology Physician
  • Cortlandt Manor, NY
  • NPI 1720092224
  NPD (past)
• Domingo CP Favale

  • Urology Physician
  • Cortlandt Manor, NY
  • NPI 1801818760
  NPD (past)
• Joseph Fisch, MD

  • Urology Physician
  • West Islip, NY
  • NPI 1609942325
  NPD (past)
• Altan Kadri Ilkay, MD

  • Urology Physician
  • East Setauket, NY
  • NPI 1578623724
  NPD (past)
• Francis Gerard Martinis, M.D.

  • Urology Physician
  • Port Jefferson Station, NY
  • NPI 1952345373
  NPD (past)
• Joshua Pearlman, MD

  • Anesthesiology Physician
  • Huntington, NY
  • NPI 1124098751
  NPD (past)
• Michael Joseph Piecuch, M.D.

  • Urology Physician
  • Middletown, NY
  • NPI 1912263112
  NPD (past)
• Mustafizur Rahman, MD

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1114002508
  NPD (past)
• Roberto Rappa, M.D.

  • Anesthesiology Physician
  • Huntington, NY
  • NPI 1851597025
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1053417402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 STEAM WAY STE A102",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652233",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 NINA WAY",
            "city": "WARMINSTER",
            "state": "PA",
            "postal_code": "189742826",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "595 W State St",
            "address_purpose": "LOCATION",
            "city": "Doylestown",
            "state": "PA",
            "postal_code": "189012554",
            "country_code": "US",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "656 E Swedesford Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wayne",
            "state": "PA",
            "postal_code": "190871622",
            "country_code": "US",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "593 W State St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Doylestown",
            "state": "PA",
            "postal_code": "189012542",
            "country_code": "US",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1068 W Baltimore Pike",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "190635104",
            "country_code": "US",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Lawn Ave",
            "address_purpose": "LOCATION",
            "city": "Sellersville",
            "state": "PA",
            "postal_code": "189601548",
            "country_code": "US",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "PA",
            "postal_code": "190133902",
            "country_code": "US",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Lansdale",
            "state": "PA",
            "postal_code": "194461259",
            "country_code": "US",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "774 Christiana Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197134219",
            "country_code": "US",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1320 Broadcasting Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Wyomissing",
            "state": "PA",
            "postal_code": "196103222",
            "country_code": "US",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 Newtown Rd",
            "address_purpose": "LOCATION",
            "city": "Warminster",
            "state": "PA",
            "postal_code": "189745221",
            "country_code": "US",
            "telephone_number": "847-544-5880",
            "fax_number": "512-872-5105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KEYSTONE KIDNEY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "SABLESAK",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "847-544-5880",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QL0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Lithotripsy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack E Keller, DMD
• Jessica Elisabeth Keller, DPT
• Kaitlin M Kennedy, MSW
• Kenneth a Sperling Corp
• Maria Teresa Kesselring, DPT
• Keystone Medical Urgent Care, LLC
• Helen Khusid, D.O.
• Veriko Khvedelidze, IBCLC
• Theresa G Kiely
• Mark P Kienle, MD, DMD

• Clinic/Center in Warminster, PA
• Providers in Warminster, PA by specialty
• Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.