Tyler Dialysis LLC
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Brooklawn, NJ
NPI 1154789659 · NPPES record last updated Aug 22, 2025
Key facts
- NPI
- 1154789659
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- License
- 24993 (NJ)
- Legal business name
- TYLER DIALYSIS LLC
- Practice address
- 700 Crescent Blvd
Ste 10B
Brooklawn, NJ 08030-2797 - Phone
- (856) 456-1230
- Fax
- (856) 742-7094
- NPI assigned
- Jan 29, 2016
- Organization subpart
- No
Authorized official
- Name
- Samuel Wey
- Title
- VP, Licensure & Certification
- Phone
- (615) 341-6641
Other NPIs with the same Medicare PAC ID 4
Member of 1
Affiliated clinicians 2
-
Robert Fleyshman, M.D.
Medicare Care Compare: Dialysis facility
- Listed as
- DaVita Brooklawn Dialysis
- Overall star rating
- ★★☆☆☆ 2.0 of 5
- Ownership
- Profit
- Certified
- Oct 20, 2017
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 19
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D2129870 | Brooklawn Dialysis | Certificate of waiver | Apr 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180205000804 | NJ | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 4284882036 | Practice locations: Brooklawn, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | 24993 | NJ | Yes |
Addresses
Primary practice location
700 Crescent Blvd
Ste 10B
Brooklawn, NJ 08030-2797
Mailing address
5200 Virginia Way
L & C Dept
Brentwood, TN 37027-7569
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0610666 | Medicaid | NJ |
Other names
- Brooklawn Dialysis
Other providers in Brooklawn, NJ
All providers in Brooklawn, NJ · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.