Ridgewood Dialysis Center, Inc

Primary specialty

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

License

7003241R Issued in NY

Legal business name

RIDGEWOOD DIALYSIS CENTER, INC

Practice address

385 Seneca Ave
Ridgewood, NY 11385-1340

Phone

(718) 366-1111

Fax

(718) 821-2956

NPI assigned

Jul 14, 2005

Organization subpart

No

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

Authorized official

Name

J. Ganesh Bhat, MD

Title

President

Phone

(718) 366-1111

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Ridgewood Dialysis Center, Inc

  dba Central Park Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New York, NY
  • NPI 1245586395

  2264477835

  Same PAC ID
• Ridgewood Dialysis Center, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • College Point, NY
  • NPI 1467451252

  2264477835

  Same PAC ID

Listed as

Atlantic DMS - Ridgewood Seneca AveCCN 332541

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 9, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Atlantic Dialysis Management Services

Dialysis stations

43

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

CLIA laboratory certificates

Tax ID family

Central Park Dialysis Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Ridgewood Dialysis Center, Inc

  dba Central Park Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New York, NY
  • NPI 1245586395
  NPD tax ID
• Ridgewood Dialysis Center, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • College Point, NY
  • NPI 1467451252
  NPD tax ID

Affiliated clinicians 2

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

• Premila Bhat, M.D.

  • Nephrology Physician
  • College Point, NY
  • NPI 1083818546

  Dialysis facility

  Care Compare affiliation Name & address match
• Bhavani Mahankali, MD

  • Specialist
  • Ridgewood, NY
  • NPI 1447208277

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425427200000",
    "number": "1467451229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23-14 COLLEGE POINT BLVD",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113562526",
            "telephone_number": "718-366-1111",
            "fax_number": "718-821-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 SENECA AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113851340",
            "telephone_number": "718-366-1111",
            "fax_number": "718-821-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEWOOD DIALYSIS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2015-03-04",
        "status": "A",
        "authorized_official_last_name": "BHAT",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "GANESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-366-1111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "7003241R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "005333",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01280184",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ridgewood Acupuncture PC
• Ridgewood Bushwick Nephrology Associates,PLLC
• Ridgewood Chemists Inc
• Ridgewood City Pharmacy Inc. (Ridgewood City Pharmacy)
• Ridgewood Dental Group
• Ridgewood Medical Diagnostic PC
• Ridgewood Optical Warehouse Outlet Corp.
• Ridgewood Optical, Inc.
• Ridgewood Pharmacy Express Inc
• Ridgewood Volunteer Ambulance Corps Inc

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.