Organization Active NPI

Home Dialysis of Santa Fe, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Santa Fe, NM
National Provider Identifier
1124477112
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
HOME DIALYSIS OF SANTA FE, LLC
Practice address
2904 Rodeo Park Dr E Ste 300a-1
Santa Fe, NM 87505-6305
Phone
(505) 467-8199
Fax
(505) 467-8519
NPI assigned
Jun 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Authorized official

Name
Biju Cherian, M.D.
Title
Managing Member
Phone
(505) 264-8120

Specialties & licenses 1

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

Addresses

Primary practice location

2904 Rodeo Park Dr E Ste 300a-1
Santa Fe, NM 87505-6305

Mailing address

PO Box 22566
Santa Fe, NM 87502-2566
Phone (505) 467-8199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161109002679 NM Part A Provider - End-Stage Renal Disease Facility (ESRD) 2860771128 Practice locations: Santa Fe, NM

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
322557-Home Dialysis of Santa Fe,LLCCCN 322557
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Apr 24, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
8

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2125018Home Dialysis of Santa Fe2904 Rodeo Park Dr E Ste 300a-1, Santa Fe, NM 87505Certificate of waiverJan 29, 2027

National Provider Directory

National Provider Directory

Locations

2904 Rodeo Park Dr E
Ste 300A
Santa Fe, NM 87505
Phone (505) 467-8199

2904 Rodeo Park Dr E
Ste 300A1
Santa Fe, NM 87505
Phone (505) 467-8199

Practitioners & affiliated clinicians

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1124477112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22566",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875022566",
            "telephone_number": "505-467-8199",
            "fax_number": "505-467-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 RODEO PARK DR E STE 300A-1",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056305",
            "telephone_number": "505-467-8199",
            "fax_number": "505-467-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME DIALYSIS OF SANTA FE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "CHERIAN",
        "authorized_official_first_name": "BIJU",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "505-264-8120",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.