Liberty Dialysis-Runnemede LLC
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Runnemede, NJ
NPI 1487849337 · NPPES record last updated Sep 1, 2026
Key facts
- NPI
- 1487849337
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- LIBERTY DIALYSIS-RUNNEMEDE LLC
- Practice address
- 170 E 9TH Ave Ste B
Runnemede, NJ 08078-1118 - Phone
- (856) 312-0101
- Fax
- (856) 312-0022
- NPI assigned
- Sep 12, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- FRESENIUS MEDICAL CARE HOLDINGS, INC.
Authorized official
- Name
- Denise Wright
- Title
- Vice President
- Phone
- (781) 676-5200
Member of 1
Member organizations 1
Practitioners 1
-
Shwu-Miin Chen, M.D.
Affiliated clinicians 5
-
Samia Fatima Mian, M.D.
-
Nitesh M Patel, D.O.
-
Daniel Ra, D.O.
-
Mark Brian Schuster, D.O.
Medicare Care Compare: Dialysis facility
- Listed as
- FKC Liberty Runnemede
- Overall star rating
- ★★★☆☆ 3.0 of 5
- Ownership
- Profit
- Certified
- Jun 20, 2008
- Medicare certification status
- Active
- Chain
- Fresenius Medical Care
- Dialysis stations
- 18
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D1080574 | FMC-Liberty Dialysis-Runnemede | Certificate of waiver | Feb 25, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071218000463 | NJ | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 0143310813 | Practice locations: Runnemede, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
170 E 9TH Ave Ste B
Runnemede, NJ 08078-1118
Mailing address
170 E 9TH Ave Ste B
Runnemede, NJ 08078-1118
Phone (856) 312-0101
Other names
- LIBERTY DIALYSIS-RUNNEMEDE LLC
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC / Office Ally |
Other providers in Runnemede, NJ
- George Kofa Kieh
- Edward Tae Kim
- Zenaida Serrano Kirkland
- William Laplant
- Robert S. Leavy
- Ellen R Little
- Ivan Rafael Lockward Jr.
- Nicholas Ma
- Esther Malave
- Debra McMire
All providers in Runnemede, NJ · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.