NPIMap

University Hospital of Brooklyn Suny Downstate Health Sciences Univers

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Brooklyn, NY

NPI 1528027414 · NPPES record last updated Aug 16, 2022

Key facts

NPI
1528027414
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
License
7001037H (NY)
Legal business name
UNIVERSITY HOSPITAL OF BROOKLYN SUNY DOWNSTATE HEALTH SCIENCES UNIVERS
Practice address
710 Parkside Ave
Brooklyn, NY 11203-1507
Phone
(718) 826-4931
Fax
(718) 826-5045
NPI assigned
Mar 21, 2006
Organization subpart
No

Authorized official

Name
Mr. Sean P Smith, CPA
Title
Sr Associate VP/Deputy Cfo
Phone
(718) 826-4943

Other NPIs with the same Medicare PAC ID 4

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

Corporate family (same tax ID) 4

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 175

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 175

Affiliated clinicians 5

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

Medicare Care Compare: Dialysis facility

Listed as
Suny Parkside Dialysis Center CCN 333544
Overall star rating
★★★☆☆ 3.0 of 5
Ownership
Non-profit
Certified
Dec 22, 2000
Medicare certification status
Active (Provider of Services file)
Dialysis stations
24

Source: Medicare Care Compare. Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0991069Suny Downstate Medical Center Parkside Dialysis
710 Parkside Avene, Brooklyn, NY 11203		Certificate of waiverMar 26, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220811003607 NY Part a Provider - End-Stage Renal Disease Facility (ESRD) 7113318122 Practice locations: Brooklyn, NY

National Provider Directory

Tax ID family
University Hospital of Brooklyn Suny Downstate Health Sciences Univers (5 organizations share this tax ID)

Locations

350 5th Ave
Brooklyn, NY 11215
Phone (718) 369-7603

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 7001037H NY Yes

Addresses

Primary practice location

710 Parkside Ave
Brooklyn, NY 11203-1507

Mailing address

710 Parkside Ave
Brooklyn, NY 11203-1507
Phone (718) 826-4931

Other names

  • SUNY Parkside Dialysis Center Doing business as
  • University Hospital of Brooklyn Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 16, 2022.

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1528027414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 PARKSIDE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031507",
            "telephone_number": "718-826-4931",
            "fax_number": "718-826-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 PARKSIDE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031507",
            "telephone_number": "718-826-4931",
            "fax_number": "718-826-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY HOSPITAL OF BROOKLYN SUNY DOWNSTATE HEALTH SCIENCES UNIVERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SR ASSOCIATE VP/DEPUTY CFO",
        "authorized_official_telephone_number": "718-826-4943",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "7001037H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUNY Parkside Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Hospital of Brooklyn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

All providers in Brooklyn, NY · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New York

Sources for this page

Verify at the official NPI Registry.