NPIMap

Organization Active NPI

Dialyze Direct Il LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Oak Park, IL
National Provider Identifier
1073163465
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DIALYZE DIRECT IL LLC
Practice address
715 Lake St
Oak Park, IL 60301-1422
Phone
(732) 806-9990
NPI assigned
Sep 17, 2019
Last updated
Sep 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Authorized official

Name
Joshua Rothenberg
Title
Coo
Phone
(732) 806-9990

Specialties & licenses 1

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

Addresses

Primary practice location

715 Lake St
Oak Park, IL 60301-1422

Mailing address

3297 State Route 66
Neptune, NJ 07753-2762

Other names 1

  • Dialyze Direct IL - Oak Park Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190307002733 IL Part A Provider - End-Stage Renal Disease Facility (ESRD) 7315286424 1 other NPI on this enrollment
Practice locations: Oak Park, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Dialysis Direct - Oak ParkCCN 142676
Overall star rating
1.0 of 5
Ownership
Profit
Certified
Feb 1, 2005
Medicare certification status
ActiveFrom the Provider of Services file

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

Practitioners & affiliated clinicians

Affiliated clinicians 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1073163465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3297 STATE ROUTE 66",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011422",
            "telephone_number": "732-806-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYZE DIRECT IL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "ROTHENBERG",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "732-806-9990"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dialyze Direct IL - Oak Park",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.