Organization Active NPI

Santa Clarita Dialysis, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Santa Clarita, CA
National Provider Identifier
1083087928
Registry record updated Oct 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SANTA CLARITA DIALYSIS, LLC
Practice address
23421 Lyons Ave
Santa Clarita, CA 91355-3028
Phone
(818) 365-1194
NPI assigned
Oct 31, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2015

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

Authorized official

Name
Omaran Abdeen, MD
Title
Managing Partner
Phone
(818) 365-1194

Specialties & licenses 1

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

Addresses

Primary practice location

23421 Lyons Ave
Santa Clarita, CA 91355-3028

Mailing address

11550 Indian Hills Rd
Suite 371
Mission Hills, CA 91345-1200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160316002558 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 0143526178 Practice locations: Santa Clarita, CA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Santa Clarita Dialysis, LLCCCN 552819
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Oct 16, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
24

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2106358Santa Clarita Dialysis LLC23421 Lyons Ave, Santa Clarita, CA 91355Certificate of waiverDec 15, 2027

National Provider Directory

National Provider Directory

Locations

11550 Indian Hills Rd
Ste 371
Mission Hills, CA 91345
Phone (818) 365-1194

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 5

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": "1446249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446249600000",
    "number": "1083087928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11550 INDIAN HILLS RD",
            "address_2": "SUITE 371",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23421 LYONS AVE",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913553028",
            "telephone_number": "818-365-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA CLARITA DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-31",
        "last_updated": "2015-10-31",
        "status": "A",
        "authorized_official_last_name": "ABDEEN",
        "authorized_official_first_name": "OMARAN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "818-365-1194",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2015; 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.