NPIMap

Organization Active NPI

Western New York DC, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Buffalo, NY
National Provider Identifier
1508948050
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
1401229R Issued in NY
Legal business name
WESTERN NEW YORK DC, LLC
Practice address
3 Gates Cir
Buffalo, NY 14209-1120
Phone
(716) 887-4736
Fax
(716) 887-4342
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Authorized official

Name
Mr. Herbert S Lawson
Title
Cfo
Phone
(303) 785-7521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 1401229R NY Primary

Addresses

Primary practice location

3 Gates Cir
Buffalo, NY 14209-1120

Mailing address

2100 Central Ave
Suite 201
Boulder, CO 80301-2838
Phone (303) 785-7523

Other identifiers 4

IdentifierTypeStateIssuer
2VOtherNYINDEPENDENT HEALTH
00030026201OtherNYUNIVERA INSURANCE COMPANY
01984981MedicaidNY
000000378000OtherNEBLUE CROSS NUMBER

Other names 1

  • Gates Circle Dialysis Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Knickerbocker Dialysis Inc65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1508948050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CENTRAL AVE",
            "address_2": "SUITE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012838",
            "telephone_number": "303-785-7523",
            "fax_number": "303-444-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 GATES CIR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142091120",
            "telephone_number": "716-887-4736",
            "fax_number": "716-887-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN NEW YORK DC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-785-7521",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "1401229R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "2V",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA INSURANCE COMPANY",
            "identifier": "00030026201",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01984981",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "000000378000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gates Circle Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.