NPIMap

Organization Active NPI

Renal Centers of North Jersey, LLC

Doing business as Lincoln Park Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lincoln Park, NJ
National Provider Identifier
1215908926
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
22359 Issued in NJ
Legal business name
RENAL CENTERS OF NORTH JERSEY, LLC
Doing business as
Lincoln Park Dialysis Center
Practice address
6 Frassetto Way
A
Lincoln Park, NJ 07035-2058
Phone
(973) 872-0099
Fax
(973) 872-0230
NPI assigned
Jan 30, 2006
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. Jerry Green
Title
Secretary
Phone
(562) 495-8075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 22359 NJ Primary

Addresses

Primary practice location

6 Frassetto Way
A
Lincoln Park, NJ 07035-2058

Mailing address

1 World Trade Ctr
2500
Long Beach, CA 90831-0002
Phone (562) 495-8075

Other identifiers 1

IdentifierTypeStateIssuer
6820301MedicaidNJ

Other names 1

  • LINCOLN PARK DIALYSIS CENTER Doing business as

National Provider Directory

National Provider Directory

Locations

6 Frassetto Way
Ste A
Lincoln Park, NJ 07035
Phone (973) 872-0099

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215908926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WORLD TRADE CTR",
            "address_2": "2500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908310002",
            "telephone_number": "562-495-8075",
            "fax_number": "562-495-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 FRASSETTO WAY",
            "address_2": "A",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070352058",
            "telephone_number": "973-872-0099",
            "fax_number": "973-872-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL CENTERS OF NORTH JERSEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "562-495-8075",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NJ",
            "license": "22359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6820301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LINCOLN PARK DIALYSIS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln Park, NJ

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.