NPIMap

Organization Active NPI

Ridgewood Dialysis Center, Inc

Doing business as Central Park Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New York, NY
National Provider Identifier
1245586395
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
RIDGEWOOD DIALYSIS CENTER, INC
Doing business as
Central Park Dialysis Center
Practice address
1249 5TH Ave
New York, NY 10029-4413
Phone
(718) 483-7440
NPI assigned
Jul 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Authorized official

Name
J. Ganesh Bhat, MD
Title
President
Phone
(718) 366-1111

Specialties & licenses 1

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

Addresses

Primary practice location

1249 5TH Ave
New York, NY 10029-4413

Mailing address

2314 College Point Blvd
College Point, NY 11356-2526
Phone (718) 483-7440

Other identifiers 1

IdentifierTypeStateIssuer
03566387MedicaidNY

Other names 1

  • Central Park Dialysis Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120820000721 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 2264477835 Practice locations: New York, NY

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Atlantic DMS - Central Park Fifth AveCCN 332514
Overall star rating
2.0 of 5
Ownership
Non-profit
Certified
Sep 3, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Atlantic Dialysis Management Services
Dialysis stations
22

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

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
33D2145466Central Park Dialysis Center1249 5TH Ave - 2ND Floor, New York, NY 10029Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Central Park Dialysis Center3 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.

Locations

2314 College Point Blvd
College Point, NY 11356
Phone (347) 312-3034

1249 5th Ave
Fl 2
New York, NY 10029

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425427200000",
    "number": "1245586395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 COLLEGE POINT BLVD",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113562526",
            "telephone_number": "718-483-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294413",
            "telephone_number": "718-483-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEWOOD DIALYSIS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-26",
        "last_updated": "2015-03-04",
        "status": "A",
        "authorized_official_last_name": "BHAT",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "GANESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-366-1111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03566387",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Park Dialysis Center",
            "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 Mar 4, 2015; 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.