Organization Active NPI

Bayview Nephrology, Inc.

  • Nephrology Physician
  • Erie, PA
National Provider Identifier
1194761643
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
BAYVIEW NEPHROLOGY, INC.
Practice address
350 E Bayfront Pkwy
Unit C
Erie, PA 16507-2410
Phone
(814) 455-2279
Fax
(814) 871-1786
NPI assigned
Jun 22, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Debra Maria Dragovan, M.B.A.
Title
Practice Manager
Phone
(814) 455-2279

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

350 E Bayfront Pkwy
Unit C
Erie, PA 16507-2410

Mailing address

350 E Bayfront Pkwy
Unit C
Erie, PA 16507-2410
Phone (814) 455-2279

Other identifiers 1

IdentifierTypeStateIssuer
0015395900006MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408000102 PA Part B Supplier - Clinic/Group Practice 0547253056 Receives reassigned benefits from 6 practitioners
Practice locations: Erie, PA

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
39D0184151Bayview Nephrology Inc350 East Bayfront Parkway, Erie, PA 16507Provider-performed microscopyAug 9, 2027

National Provider Directory

National Provider Directory

Locations

350 E Bayfront Pkwy
Ste C
Erie, PA 16507
Phone (814) 455-2279

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194761643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E BAYFRONT PKWY",
            "address_2": "UNIT C",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165072410",
            "telephone_number": "814-455-2279",
            "fax_number": "814-871-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E BAYFRONT PKWY",
            "address_2": "UNIT C",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165072410",
            "telephone_number": "814-455-2279",
            "fax_number": "814-871-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYVIEW NEPHROLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DRAGOVAN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "814-455-2279",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015395900006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • 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.