Active NPI
Replacement Associates LLC
Doing business as Upper Eastside Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- New York, NY
National Provider Identifier
1215928981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- 7002180R
- Legal business name
- REPLACEMENT ASSOCIATES LLC
- Doing business as
- Upper Eastside Dialysis
- Practice address
- 210 E 86TH St 3Rd Floor
New York, NY 10028-3003 - Phone
- (212) 794-2850
- Fax
- (212) 794-2187
- NPI assigned
- Nov 2, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Dominic Licciardi
- Title
- Administrator
- Phone
- (718) 987-5942
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | 7002180R | NY | Primary |
Addresses
Primary practice location
210 E 86TH St 3Rd Floor
New York, NY 10028-3003
Mailing address
97 New Dorp LN
Staten Island, NY 10306-2364
Phone (718) 448-5641
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02717999 | Medicaid | NY | |
| 00519755 | Medicaid | NY |
Other names 1
- Upper Eastside Dialysis
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
210 E 86th St
Fl 3
New York, NY 10028
Phone (212) 794-2850
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nephrology Physician
- New York, NY
- NPI 1326063215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1697068800000",
"number": "1215928981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97 NEW DORP LN",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103062364",
"telephone_number": "718-448-5641",
"fax_number": "718-876-5969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 E 86TH ST 3RD FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100283003",
"telephone_number": "212-794-2850",
"fax_number": "212-794-2187"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REPLACEMENT ASSOCIATES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-02",
"last_updated": "2023-10-12",
"certification_date": "2023-10-12",
"status": "A",
"authorized_official_last_name": "LICCIARDI",
"authorized_official_first_name": "DOMINIC",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "718-987-5942",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": "NY",
"license": "7002180R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02717999",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00519755",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Upper Eastside Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.