Organization Active NPI

Usrc South Flushing, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Flushing, NY
National Provider Identifier
1104299254
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
USRC SOUTH FLUSHING, LLC
Practice address
7112 Park Ave
Flushing, NY 11365-4105
Phone
(718) 591-4010
Fax
(718) 591-4014
NPI assigned
Nov 10, 2015
Organization subpart
Yes
Parent organization
U.S. RENAL CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Thomas L. Weinberg
Title
Chairman, Authorized Official
Phone
(214) 736-2700

Specialties & licenses 1

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

Addresses

Primary practice location

7112 Park Ave
Flushing, NY 11365-4105

Mailing address

PO Box 842688
Dallas, TX 75284-2688
Phone (718) 591-4010

Other names 1

  • U.S. Renal Care South Flushing Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160429000144 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 4688973480 Practice locations: Flushing, NY

National Provider Directory

National Provider Directory
Part of
US Renal Care Inc

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1104299254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842688",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752842688",
            "telephone_number": "718-591-4010",
            "fax_number": "718-591-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7112 PARK AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113654105",
            "telephone_number": "718-591-4010",
            "fax_number": "718-591-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC SOUTH FLUSHING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2015-11-10",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHAIRMAN, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care South Flushing Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.