Dialyze Direct Wi, LLC

Primary specialty

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

Legal business name

DIALYZE DIRECT WI, LLC

Practice address

N25W23131 Paul Rd
Pewaukee, WI 53072-5762

Phone

(732) 806-9990

NPI assigned

Jan 14, 2021

Last updated

Nov 8, 2021By 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

Joshua Rothenberg

Title

President

Phone

(732) 806-9990

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1154910081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3297 STATE ROUTE 66",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N25W23131 PAUL RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725762",
            "telephone_number": "732-806-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYZE DIRECT WI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "ROTHENBERG",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-806-9990"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Marie Dellemann, RN
• Stephanie Hall Delmore, LPC
• Patricia Dennison, RN
• Kesha Desai Rajguru, O.D.
• Harshita Desai-Walter, LPC
• Diciaula Health Services, SC
• Tad Alan Diciaula, D.C.
• Jolie A Dillaber, RN
• Nicholas Dillon, M.S., M.A., SACIT
• Marie Dittmer, MA, RDN

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.