Active NPI
Pineview Dialysis Clinic LLC
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Clinton, MD
National Provider Identifier
1396418364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- PINEVIEW DIALYSIS CLINIC LLC
- Practice address
- 9106 Pine View LN
Clinton, MD 20735-3229 - Phone
- (301) 856-2930
- NPI assigned
- Jul 27, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brian Flinglass, CPA
- Title
- VP Finance
- Phone
- (410) 766-1995
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
9106 Pine View LN
Clinton, MD 20735-3229
Mailing address
8028 Ritchie Hwy Ste 210
Pasadena, MD 21122-1075
Phone (410) 766-1995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210913002398 | MD | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 0042616252 | Practice locations: Clinton, MD |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627344000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1627344000000",
"number": "1396418364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8028 RITCHIE HWY STE 210",
"city": "PASADENA",
"state": "MD",
"postal_code": "211221075",
"telephone_number": "410-766-1995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9106 PINE VIEW LN",
"city": "CLINTON",
"state": "MD",
"postal_code": "207353229",
"telephone_number": "301-856-2930"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PINEVIEW DIALYSIS CLINIC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-07-27",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A",
"authorized_official_last_name": "FLINGLASS",
"authorized_official_first_name": "BRIAN",
"authorized_official_title_or_position": "VP FINANCE",
"authorized_official_telephone_number": "410-766-1995",
"authorized_official_credential": "CPA"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
- Angelica Nicolina Ferrazzi Petrous, DNP, APRN, AGPCNP-BC
- Tamika La Cher Phelps
- Physician Imaging of Washington Hospital Center, LLC (MedStar Radiology Network at Southern Maryland)
- Ma Riza Pico, PT
- Wendell C. Pierson, M.D.
- Pineview Extended Care Centre, Inc. (FutureCare Pineview)
- Pineview Extended Care Centre, Inc. (FutureCare Pineview)
- Pinnacle Enrichment Healthcare Services, LLC
- Robin Platt, LGPC
- Ivanna Plymouth, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.