Santa Clarita Kidney Center, Inc.

Primary specialty

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

License

930000242 Issued in CA

Legal business name

SANTA CLARITA KIDNEY CENTER, INC.

Practice address

23861 McBean Pkwy
E-11
Valencia, CA 91355-2058

Phone

(661) 222-7370

Fax

(661) 222-7374

NPI assigned

Feb 2, 2006

Last updated

Nov 29, 2016By the provider in NPPES

Organization subpart

No

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) 421-2690

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Santa Clarita Kidney CenterCCN 052778

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Feb 19, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Other

Dialysis stations

24

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kris Eileen-Hayn Rock, RDN

  • Registered Dietitian
  • Valencia, CA
  • NPI 1366111429
  NPD (past)

Affiliated clinicians 4

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

• Brian Barrios Ayuste, M.D.

  • Internal Medicine Physician
  • Granada Hills, CA
  • NPI 1104003458

  Dialysis facility

  Care Compare affiliation Name & address match
• Anant J Desai, MD

  • Nephrology Physician
  • Granada Hills, CA
  • NPI 1871500389

  Dialysis facility

  Care Compare affiliation Name & address match
• Ramya Ramesh Malchira, MD.

  • Nephrology Physician
  • Santa Clarita, CA
  • NPI 1275810921

  Dialysis facility

  Care Compare affiliation Name & address match
• Kalyani Nilesh Mehta, MD

  • Nephrology Physician
  • Granada Hills, CA
  • NPI 1699899724

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1275505588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 COVER ST",
            "address_2": "STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081790",
            "telephone_number": "562-421-2690",
            "fax_number": "562-421-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23861 MCBEAN PKWY",
            "address_2": "E-11",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552058",
            "telephone_number": "661-222-7370",
            "fax_number": "661-222-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA CLARITA KIDNEY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "562-421-2690",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "930000242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC02778F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Santa Clarita Emergency Medical Group Inc
• Santa Clarita Family Optometry, Inc
• Santa Clarita Hearing Center, Incorporated (Santa Clarita Hearing Center)
• Santa Clarita Home Health Nurses Inc
• Santa Clarita Hospice Care Inc
• Santa Clarita Neurology Medical Group Inc
• Santa Clarita Pediatrics
• Santa Clarita Procedure Centers
• Santa Clarita Valley Eye Medical Group Inc (SCV Eye Center)
• Sandra Santana, PSY.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Valencia, CA
• Providers in Valencia, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.