Usrc Bedford, LLC

Primary specialty

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

Legal business name

USRC BEDFORD, LLC

Practice address

141 Memorial Dr
Everett, PA 15537-7030

Phone

(814) 623-2977

Fax

(814) 623-2944

NPI assigned

Aug 1, 2016

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INCAs reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• U.S. Renal Care Bedford Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Listed as

USRC BedfordCCN 392612

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Mar 15, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

11

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

CLIA laboratory certificates

Part of

US Renal Care Inc

Affiliated clinicians 2

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

• Faina Gurevich, M.D.

  • Nephrology Physician
  • Johnstown, PA
  • NPI 1457535031

  Dialysis facility

  Care Compare affiliation Name & address match
• Duminda S Siripala, M.D.

  • Nephrology Physician
  • Altoona, PA
  • NPI 1932480571

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470009600000",
    "number": "1104379726",
    "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": "214-736-2700",
            "fax_number": "214-736-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MEMORIAL DR",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155377030",
            "telephone_number": "814-623-2977",
            "fax_number": "814-623-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC BEDFORD, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC",
        "enumeration_date": "2016-08-01",
        "last_updated": "2016-08-01",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "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 Bedford Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Darryl Keef Warner, D,C.
• Shannon Weiss

• All providers in Everett, PA
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; 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.