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

2314 College Point Blvd
College Point, NY 11356-2526

Phone

(718) 762-3330

Fax

(718) 762-1537

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

Dr. J. Ganesh Bhat, MD

Title

President

Phone

(718) 366-1111

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Springfield Dialysis Center Other name

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

  • 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
  • Ridgewood, NY
  • NPI 1467451229

  2264477835

  Same PAC ID

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

  • 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
  • Ridgewood, NY
  • NPI 1467451229
  NPD tax ID

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1467451252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 COLLEGE POINT BLVD",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113562526",
            "telephone_number": "718-762-3330",
            "fax_number": "718-762-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 COLLEGE POINT BLVD",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113562526",
            "telephone_number": "718-762-3330",
            "fax_number": "718-762-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEWOOD DIALYSIS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2019-11-14",
        "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_name_prefix": "Dr.",
        "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03007572",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "018788",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springfield Dialysis Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Springfield Dialysis Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sung Eun Ra, L.AC.
• Elizabeth Ramos
• Jeffrey M Reising, O.D.
• Janice Ren
• Ellen Marie Richter, PH.D. PSYCHOLOGY
• Rachelle Rivere
• Rachel Roberts, OTR/L
• Olga A Rodriguez, FNP-BC
• Sharlyn Melyssa Rodriguez, CCC SLP
• Dorothea Rogers, RPH

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in College Point, NY
• Providers in College Point, 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 Nov 14, 2019; 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.

Verify at the official NPI Registry.