Usrc Altoona LLC

Primary specialty

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

Legal business name

USRC ALTOONA LLC

Practice address

118 E Chestnut Ave
Altoona, PA 16601-5202

Phone

(814) 943-2569

Fax

(814) 942-2953

NPI assigned

Feb 24, 2011

Organization subpart

Yes

Parent organization

U S RENAL CARE INCAs reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• U S Renal Care Altoona Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Listed as

USRC AltoonaCCN 392786

Overall star rating

3.0 of 5

Ownership

Profit

Certified

May 19, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

19

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

US Renal Care Inc

Locations

Practitioners 1

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

• Katey Fox, MSW, LSW

  • Social Worker
  • Altoona, PA
  • NPI 1518790120
  NPD (past)

Affiliated clinicians 3

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

• Pawan K Gupta, MD

  • Nephrology Physician
  • Altoona, PA
  • NPI 1649287012

  Dialysis facility

  Care Compare affiliation Name & address match
• Angel Q Raposas, MD

  • Nephrology Physician
  • Altoona, PA
  • NPI 1407932049

  Dialysis facility

  Care Compare affiliation Name & address match
• Duminda S Siripala, M.D.

  • Nephrology Physician
  • Altoona, PA
  • NPI 1932480571

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1265739411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 DALLAS PKWY",
            "address_2": "SUITE 350",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934370",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E CHESTNUT AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166015202",
            "telephone_number": "814-943-2569",
            "fax_number": "814-942-2953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC ALTOONA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U S RENAL CARE INC",
        "enumeration_date": "2011-02-24",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "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": "1026011830001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U S Renal Care Altoona Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Altoona, PA
• Providers in Altoona, PA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; 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.