East Palmdale Dialysis Center, LLC

Primary specialty

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

License

A41776 Issued in CA

Legal business name

EAST PALMDALE DIALYSIS CENTER, LLC

Practice address

2710 E Palmdale Blvd
Palmdale, CA 93550-4946

Phone

(661) 456-1500

Fax

(661) 265-7089

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John H Fisher, M.D.NPI 1699777334

Title

Owner/Ceo

Phone

(661) 456-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

East Palmdale Dialysis CenterCCN 052867

Overall star rating

2.0 of 5

Ownership

Profit

Certified

May 8, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

20

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• High Desert Hemodialysis, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Palmdale, CA
  • NPI 1811917362

  Member Of

  NPD member

Member organizations 1

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

• High Desert Hemodialysis, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Palmdale, CA
  • NPI 1811917362

  Member Of

  NPD member

Locations

Practitioners 1

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

• John H.H. Fisher, M.D.

  • Nephrology Physician
  • Palmdale, CA
  • NPI 1699777334
  NPD (past) Authorized official

Affiliated clinicians 1

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

• John H.H. Fisher, M.D.

  • Nephrology Physician
  • Palmdale, CA
  • NPI 1699777334

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316968977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504946",
            "telephone_number": "661-456-1500",
            "fax_number": "661-265-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504946",
            "telephone_number": "661-456-1500",
            "fax_number": "661-265-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PALMDALE DIALYSIS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "661-456-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "A41776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC02867F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Palmdale, CA
• Providers in Palmdale, 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 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.