Brookstone Dialysis LLC

Primary specialty

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

Legal business name

BROOKSTONE DIALYSIS LLC

Practice address

15 Carbon PL
Jersey City, NJ 07305-5295

Phone

(551) 285-1016

Fax

(551) 285-1343

NPI assigned

Jan 10, 2023

Organization subpart

Yes

Parent organization

DAVITA INCAs reported in NPPES

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

Authorized official

Name

Samuel Wey

Title

VP, Licensure & Certification

Phone

(615) 320-4414

Specialties & licenses 1

Addresses

Other names 1

• Liberty Park Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Listed as

DaVita Liberty ParkCCN 312717

Ownership

Profit

Certified

Mar 12, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

19

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

Davita Inc

Member of 1

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Affiliated clinicians 2

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

• Heather Nadine Lefkowitz, MD

  • Nephrology Physician
  • West Orange, NJ
  • NPI 1659346518

  Dialysis facility

  Care Compare affiliation Name & address match
• Sonia C Simoes, MD

  • Nephrology Physician
  • Newark, NJ
  • NPI 1346406600

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1427762897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L AND C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4414",
            "fax_number": "866-865-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CARBON PL",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073055295",
            "telephone_number": "551-285-1016",
            "fax_number": "551-285-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSTONE DIALYSIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2023-01-10",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-320-4414"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Park Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Liberty Park Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Briones Family Dental, Inc.
• Noemi Brizuela, APN
• Broadstreet Healthcare Inc
• Jennifer Petra Brooks, NP
• Vernee Brittney Brooks, LPC
• Melanie Brothers, OTR/L
• Deborah Brotman, MD
• Cameron James Brown, DO
• James H Brown Jr., M.D.
• James Joseph Brown III, RPH

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.