Liberty Dialysis - North Haven LLC

Primary specialty

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

Legal business name

LIBERTY DIALYSIS - NORTH HAVEN LLC

Doing business as

U.S. Renal Care North Haven Dialysis

Practice address

510 Washington Ave
North Haven, CT 06473-1313

Phone

(203) 234-7071

Fax

(203) 234-6778

NPI assigned

Jan 1, 2007

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• U.S. Renal Care North Haven Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Listed as

USRC North Haven DialysisCCN 072532

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Jun 4, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

18

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

CLIA laboratory certificates

Part of

US Renal Care Inc

Member of 1

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

• Dialysis Newco LLC

  dba U.S. Renal Care Viera Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Viera, FL
  • NPI 1982970554

  Member Of

  NPD member

Affiliated clinicians 2

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

• Bayode Ademola Afolalu, M.D.

  • Nephrology Physician
  • Orange, CT
  • NPI 1548442726

  Dialysis facility

  Care Compare affiliation Name & address match
• Jeffrey Reynolds, MD

  • Nephrology Physician
  • Orange, CT
  • NPI 1083600381

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1336206408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 CHURCH ST",
            "address_2": "SUITE 1900",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372192301",
            "telephone_number": "615-777-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 WASHINGTON AVE",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064731313",
            "telephone_number": "203-234-7071",
            "fax_number": "203-234-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS - NORTH HAVEN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2007-01-01",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004271764",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care North Haven Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leigh Forte LPC
• Seth Leventhal
• Jennifer Elizabeth Lewis, LCSW
• LFM PLLC
• Eric Paul Liben, MD
• Todd Lichtfus, M.S., P.T., A.T.C.
• Lighthouse Counseling and Intervention LLC
• Katie Anne Limauro, APRN
• Charlotte Rose Limosani, SLP
• Garrett Linske, DPT

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in North Haven, CT
• Providers in North Haven, CT by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.