Caverns Dialysis LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

CAVERNS DIALYSIS LLC

Practice address

15-00 Pollitt Dr
Fair Lawn, NJ 07410-2732

Phone

(201) 796-1385

Fax

(201) 794-0150

NPI assigned

Aug 1, 2013

Organization subpart

No

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

Authorized official

Name

Samuel T Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Radburn Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Listed as

DaVita Radburn DialysisCCN 312637

Overall star rating

5.0 of 5

Ownership

Profit

Certified

Jun 2, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

21

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Affiliated clinicians 3

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

• Clenton L Coleman, MD

  • Nephrology Physician
  • Teaneck, NJ
  • NPI 1730379025

  Dialysis facility

  Care Compare affiliation Name & address match
• Mikhail Kotlov, M.D.

  • Nephrology Physician
  • Paramus, NJ
  • NPI 1891840872

  Dialysis facility

  Care Compare affiliation Name & address match
• Syed Raza, MD

  • Nephrology Physician
  • Paramus, NJ
  • NPI 1790766814

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1104258029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-00 POLLITT DR",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102732",
            "telephone_number": "201-796-1385",
            "fax_number": "201-794-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAVERNS DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-01",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0416479",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radburn Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Radburn Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine Carlton, APN
• Eileen Linda Caruso, LSW
• Ryan Cassilly, M.D.
• Cataract and Eye Center PC
• Michael Yurich Cate, LAC
• Ce Fair Group LLC
• Cella Foot and Ankle Specialty
• Antonella Cella, DPM
• Breanna A Cerniglia, LSW
• David Robert Chabbott, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.