Organization Active NPI

Home Dialysis of New Mexico, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1457638595
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
HOME DIALYSIS OF NEW MEXICO, LLC
Practice address
700 Lomas Blvd NE
Three Woodward Center
Albuquerque, NM 87102-2568
Phone
(505) 842-5210
NPI assigned
Nov 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Authorized official

Name
Dr. Biju Cherian, M.D.
Title
Partner
Phone
(505) 842-5210

Specialties & licenses 1

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

Addresses

Primary practice location

700 Lomas Blvd NE
Three Woodward Center
Albuquerque, NM 87102-2568

Mailing address

700 Lomas Blvd NE
Three Woodward Center
Albuquerque, NM 87102-2568
Phone (505) 842-5210

Other identifiers 1

IdentifierTypeStateIssuer
72133287MedicaidNM

National Provider Directory

National Provider Directory

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": "1320278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1457638595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 LOMAS BLVD NE",
            "address_2": "THREE WOODWARD CENTER",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022568",
            "telephone_number": "505-842-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LOMAS BLVD NE",
            "address_2": "THREE WOODWARD CENTER",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022568",
            "telephone_number": "505-842-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME DIALYSIS OF NEW MEXICO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-03",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "CHERIAN",
        "authorized_official_first_name": "BIJU",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "505-842-5210",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72133287",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.