Organization Active NPI

True North VI DC LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Riverhead, NY
National Provider Identifier
1114738358
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
TRUE NORTH VI DC LLC
Practice address
700 Old Country Rd Ste 4
Riverhead, NY 11901-2129
Phone
(631) 208-0282
Fax
(631) 208-0129
NPI assigned
Jan 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Samuel Wey
Title
Assistant Secretary
Phone
(615) 320-4414

Specialties & licenses 1

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

Addresses

Primary practice location

700 Old Country Rd Ste 4
Riverhead, NY 11901-2129

Mailing address

5200 Virginia Way
L and C Dept
Brentwood, TN 37027-7569
Phone (615) 320-4414

Other names 1

  • Peconic Bay Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250211001953 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 3476083189 Practice locations: Riverhead, NY

National Provider Directory

National Provider Directory

Member of 3

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

NPI Registry JSON

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1114738358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L AND C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLD COUNTRY RD STE 4",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012129",
            "telephone_number": "631-208-0282",
            "fax_number": "631-208-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUE NORTH VI DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "615-320-4414"
    },
    "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": "Peconic Bay Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.