North Central Pennsylvania Dialysis Clinics LLC

Primary specialty

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

Legal business name

NORTH CENTRAL PENNSYLVANIA DIALYSIS CLINICS LLC

Doing business as

Williamsport Dialysis Clinic

Practice address

1660 Sycamore Rd
Montoursville, PA 17754-9314

Phone

(570) 329-3300

Fax

(570) 329-1069

NPI assigned

Jun 15, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chester A. Amedia, MDNPI 1952306995

Title

Ceo

Phone

(330) 781-6212

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Williamsport Dialysis Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• North Central Pennsylvania Dialysis Clinics LLC

  dba Lock Haven Dialysis Clinic

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lock Haven, PA
  • NPI 1295730505

  9537077995

  Same PAC ID

Listed as

NCPDC Williamsport Dialysis ClinicCCN 392684

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Apr 19, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Chain

North Central Pennsylvania Dialysis Clinics

Dialysis stations

25

Listed as

Kidney Center Home TherapiesCCN 392880

Ownership

Profit

Certified

May 7, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Chain

North Central Pennsylvania Dialysis Clinics

Dialysis stations

2

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

CLIA laboratory certificates

Tax ID family

North Central Pennsylvania Dialysis Clinics LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• North Central Pennsylvania Dialysis Clincs LLC

  dba North Central Pennsylvania Dialysis Clinics - Grampian

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Williamsport, PA
  • NPI 1710369467
  NPD tax ID
• North Central Pennsylvania Dialysis Clinics LLC

  dba Lock Haven Dialysis Clinic

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lock Haven, PA
  • NPI 1295730505
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chester A. Amedia, MD

  • Nephrology Physician
  • Boardman, OH
  • NPI 1952306995
  NPD (past) Authorized official
• Daniel R Gandy, DO

  • Nephrology Physician
  • Montoursville, PA
  • NPI 1366427205
  NPD (past)

Affiliated clinicians 3

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

• MHD Said Al Zein, MD

  • Nephrology Physician
  • Coudersport, PA
  • NPI 1285157917

  Dialysis facility

  Care Compare affiliation Name & address match
• Bidyut Kanti Sarker, MD,MRCP(UK)

  • Nephrology Physician
  • Danville, PA
  • NPI 1285111666

  Dialysis facility

  Care Compare affiliation Name & address match
• Sam Stea

  • Nephrology Physician
  • Montoursville, PA
  • NPI 1053396994

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114922416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 SYCAMORE RD",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177549314",
            "telephone_number": "570-329-3300",
            "fax_number": "570-329-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 SYCAMORE RD",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177549314",
            "telephone_number": "570-329-3300",
            "fax_number": "570-329-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CENTRAL PENNSYLVANIA DIALYSIS CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AMEDIA",
        "authorized_official_first_name": "CHESTER",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-781-6212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1837223",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Williamsport Dialysis Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Murray, CRNA
• Kathleen Alyse Musheno, MA, CCC-SLP
• John M Nakhla
• Rachael Neatrour, DPT
• Mylea Neidig
• Charles Joseph O'Malley, DPT
• Mark Christopher Oberheim, DMD, MDS
• Mehulaben Patel
• Jennifer Patson, PHARMD
• Violeta Pesa, PT

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Montoursville, PA
• Providers in Montoursville, PA by specialty
• 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 22, 2020; 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.