NPIMap

Organization Active NPI

Independent Dialysis Foundation, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Oakland, MD
National Provider Identifier
1295746527
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
INDEPENDENT DIALYSIS FOUNDATION, INC
Practice address
888 Memorial Dr
Oakland, MD 21550-5101
Phone
(410) 468-0900
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Authorized official

Name
Mr. Zeke Ayele
Title
Director of It
Phone
(410) 468-0900

Specialties & licenses 1

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

Addresses

Primary practice location

888 Memorial Dr
Oakland, MD 21550-5101

Mailing address

840 Hollins St
Baltimore, MD 21201-1024
Phone (410) 468-0900

Other identifiers 6

IdentifierTypeStateIssuer
0704865003OtherMDCIGNA
215143OtherMDUNITED HEALTHCARE
916856-01OtherMDCAREFIRST BLUE CROSS
0125608OtherMDAETNA
AC2OtherMDFEP
3810011315MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060918000350 MD Part A Provider - End-Stage Renal Disease Facility (ESRD) 7719958503 Practice locations: Oakland, MD

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Idf - Garrett Dialysis CenterCCN 212651
Overall star rating
3.0 of 5
Ownership
Non-profit
Certified
Oct 27, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Independent Dialysis Foundation (IDF)
Dialysis stations
12

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
21D1059715Independent Dialysis Foundation Inc888 Memorial Drive, Oakland, MD 21550Certificate of waiverOct 4, 2026

National Provider Directory

National Provider Directory
Tax ID family
Independent Dialysis Foundation Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410220800000",
    "number": "1295746527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 HOLLINS ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011024",
            "telephone_number": "410-468-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 MEMORIAL DR",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215505101",
            "telephone_number": "410-468-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT DIALYSIS FOUNDATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2014-09-09",
        "status": "A",
        "authorized_official_last_name": "AYELE",
        "authorized_official_first_name": "ZEKE",
        "authorized_official_title_or_position": "DIRECTOR OF IT",
        "authorized_official_telephone_number": "410-468-0900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0704865003",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "215143",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS",
            "identifier": "916856-01",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0125608",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEP",
            "identifier": "AC2",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810011315",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; 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.