Organization 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
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
7002180R Issued in NY
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

Updated by the provider on Oct 12, 2023

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
02717999MedicaidNY
00519755MedicaidNY

Other names 1

  • Upper Eastside Dialysis Doing business as

National Provider Directory

National Provider Directory

Member 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.

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.

Verify at the official NPI Registry.