Organization Active NPI

Bayridge Sunset Park Dialysis Center Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1336175678
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
BAYRIDGE SUNSET PARK DIALYSIS CENTER INC
Practice address
140 58TH St
Building B, Box 65
Brooklyn, NY 11220-2521
Phone
(718) 567-0255
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Authorized official

Name
Ms. Lora A Zweiman
Title
Billing Manager
Phone
(914) 644-9213

Specialties & licenses 1

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

Addresses

Primary practice location

140 58TH St
Building B, Box 65
Brooklyn, NY 11220-2521

Mailing address

140 58TH St
Building B, Box 65
Brooklyn, NY 11220-2521
Phone (718) 567-0255

Other identifiers 2

IdentifierTypeStateIssuer
009232OtherEMPIRE BLUE CROSS
01635487MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120126000647 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 4486821790 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Tax ID family
Bay Ridge Sunset Park Dialysis Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

140 58th St
Ste 65
Brooklyn, NY 11220
Phone (718) 238-4980

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1336175678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 58TH ST",
            "address_2": "BUILDING B, BOX 65",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202521",
            "telephone_number": "718-567-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 58TH ST",
            "address_2": "BUILDING B, BOX 65",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202521",
            "telephone_number": "718-567-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYRIDGE SUNSET PARK DIALYSIS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "ZWEIMAN",
        "authorized_official_first_name": "LORA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "914-644-9213",
        "authorized_official_name_prefix": "Ms."
    },
    "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": "EMPIRE BLUE CROSS",
            "identifier": "009232",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01635487",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.