Simeon Dialysis LLC

Primary specialty

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

License

22344 Issued in NJ

Legal business name

SIMEON DIALYSIS LLC

Practice address

57 Willowbrook Blvd
FL 2
Wayne, NJ 07470-7045

Phone

(973) 890-2792

Fax

(973) 890-2796

NPI assigned

Dec 11, 2011

Organization subpart

No

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

Authorized official

Name

Samuel Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St Josephs Wayne Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Simeon Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Paterson, NJ
  • NPI 1639447105

  9537336334

  Same PAC ID
• Simeon Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Paterson, NJ
  • NPI 1871862730

  9537336334

  Same PAC ID

Tax ID family

Simeon Dialysis 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.

• Simeon Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Paterson, NJ
  • NPI 1639447105
  NPD tax ID
• St. Joseph'S Dialysis , LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Wayne, NJ
  • NPI 1407183940
  NPD tax ID

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• St Joseph'S Hospital and Medical Center

  • Rehabilitation Hospital Unit
  • Wayne, NJ
  • NPI 1609847870

  Member Of

  NPD member
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Castle Rock, CO
  • NPI 1386928430

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1323561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781481600000",
    "number": "1205104841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 WILLOWBROOK BLVD",
            "address_2": "FL 2",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707045",
            "telephone_number": "973-890-2792",
            "fax_number": "973-890-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMEON DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-11",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NJ",
            "license": "22344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0297852",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Josephs Wayne Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Josephs Wayne Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stuart L Siepser, MD
• Signal Neuromonitoring, LLC
• Colin Silk
• Scott W Silodor, M.D.
• Ani Silvani
• Erin Simon
• Gavrielle Beth Simon, LCSW
• Erica Stephanie Simone, ATC, OTC
• Shawne Simone, FNP
• Matthew Joel Singer, D.C.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wayne, NJ
• Providers in Wayne, NJ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.