Woodbridge Dialysis Center LLC

Primary specialty

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

Legal business name

WOODBRIDGE DIALYSIS CENTER LLC

Doing business as

Garden State Kidney Center

Practice address

345 Main St
Woodbridge, NJ 07095-1214

Phone

(732) 855-2100

Fax

(732) 855-2101

NPI assigned

Jun 17, 2014

Last updated

Jan 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sara Anne Brady

Title

Chief Nursing Officer

Phone

(208) 371-7878

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Garden State Kidney Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Listed as

DaVita Garden State DialysisCCN 312647

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Feb 20, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

19

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

CLIA laboratory certificates

Locations

Affiliated clinicians 1

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

• Alexander M Swan, MD

  • Nephrology Physician
  • Avenel, NJ
  • NPI 1346218856

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1558775536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 MAIN ST",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951214",
            "telephone_number": "732-855-2100",
            "fax_number": "732-855-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 MAIN ST",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951214",
            "telephone_number": "732-855-2100",
            "fax_number": "732-855-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBRIDGE DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CHIEF NURSING OFFICER",
        "authorized_official_telephone_number": "208-371-7878"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0451550",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Garden State Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Garden State Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Martin Willis
• Shannon Witkowski, NP-C
• Woodbridge Board of Education
• Woodbridge Centre Dental
• Woodbridge Dental LLC
• Woodbridge Medical Associates,P.a. (Woodbridge Internal Medical Associates)
• Woodbridge Medical Group, P.a (Main Street Physical Therapy)
• Woodbridge Sleep Center LLC
• Woodbridge Township School District
• Stephen D Yaremczak, D.M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Woodbridge, NJ
• Providers in Woodbridge, NJ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.