NPIMap

Organization Active NPI

North Central Pennsylvania Dialysis Clinics LLC

Doing business as Lock Haven Dialysis Clinic

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lock Haven, PA
National Provider Identifier
1295730505
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
NORTH CENTRAL PENNSYLVANIA DIALYSIS CLINICS LLC
Doing business as
Lock Haven Dialysis Clinic
Practice address
257 S Hanna St
Lock Haven, PA 17745-3644
Phone
(570) 748-3800
Fax
(570) 748-4650
NPI assigned
Jun 15, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Chester A. Amedia, MDNPI 1952306995
Title
Ceo
Phone
(330) 781-6212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

257 S Hanna St
Lock Haven, PA 17745-3644

Mailing address

257 S Hanna St
Lock Haven, PA 17745-3644
Phone (570) 748-3800

Other names 1

  • Lock Haven Dialysis Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060202000655 PA Part A Provider - End-Stage Renal Disease Facility (ESRD) 9537077995 Practice locations: Lock Haven, PA

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
NCPDC Lock Haven Dialysis CenterCCN 392678
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Feb 19, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Chain
North Central Pennsylvania Dialysis Clinics
Dialysis stations
13

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
39D2167171North Central Pennsylvania Dialysis Clinics257 S Hanna Street, Lock Haven, PA 17745Certificate of waiverJun 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
North Central Pennsylvania Dialysis Clincs LLC3 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.

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

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.

Affiliated clinicians 2

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": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295730505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 S HANNA ST",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177453644",
            "telephone_number": "570-748-3800",
            "fax_number": "570-748-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 S HANNA ST",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177453644",
            "telephone_number": "570-748-3800",
            "fax_number": "570-748-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CENTRAL PENNSYLVANIA DIALYSIS CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AMEDIA",
        "authorized_official_first_name": "CHESTER",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-781-6212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lock Haven Dialysis Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lock Haven, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.