Mohan Dialysis Center of Covina, Inc

Primary specialty

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

Legal business name

MOHAN DIALYSIS CENTER OF COVINA, INC

Practice address

638 S Glendora Ave
Glendora, CA 91740-4483

Phone

(626) 914-5553

Fax

(626) 914-5602

NPI assigned

Jun 17, 2008

Organization subpart

Yes

Parent organization

MOHAN DIALYSIS CENTER OF COVINA, INC.As reported in NPPES

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

Authorized official

Name

Mrs. Anna J Mohan

Title

Business Manager

Phone

(626) 914-5553

Specialties & licenses 2

Addresses

Other names 1

• mohan dialysis center of glendora Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Mohan Dialysis Center of Covina, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • City of Industry, CA
  • NPI 1558522151

  5193636546

  Same PAC ID
• Mohan Dialysis Center of Covina, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Covina, CA
  • NPI 1841201738

  5193636546

  Same PAC ID

Listed as

Mohan Dialysis Center of GlendoraCCN 552538

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Oct 25, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

21

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

CLIA laboratory certificates

Tax ID family

Mohan Dialysis Center of Covina Inc3 organizations share this tax ID, including this one

Part of

Mohan Dialysis Center of Covina Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Mohan Dialysis Center of Covina, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • City of Industry, CA
  • NPI 1558522151
  NPD tax ID
• Mohan Dialysis Center of Covina, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Covina, CA
  • NPI 1841201738
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Mohan Dialysis Center of Covina, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Covina, CA
  • NPI 1841201738
  NPPES parent name

Affiliated clinicians 1

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

• Krishna Jatavallabhula Mohan, MD

  • Nephrology Physician
  • Covina, CA
  • NPI 1477645786

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1285895896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 S GLENDORA AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404483",
            "telephone_number": "626-914-5553",
            "fax_number": "626-914-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 S GLENDORA AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404483",
            "telephone_number": "626-914-5553",
            "fax_number": "626-914-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAN DIALYSIS CENTER OF COVINA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOHAN DIALYSIS CENTER OF COVINA, INC.",
        "enumeration_date": "2008-06-17",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "MOHAN",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "626-914-5553",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "mohan dialysis center of glendora",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "mohan dialysis center of glendora",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Glendora, CA
• Providers in Glendora, 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 May 1, 2023; 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.