NPIMap

Organization Active NPI

Home Dialysis of Florida LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tamarac, FL
National Provider Identifier
1629773908
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
HOME DIALYSIS OF FLORIDA LLC
Practice address
5409 N State Road 7
Tamarac, FL 33319-2921
Phone
(847) 593-8460
NPI assigned
Apr 4, 2023
Last updated
Jun 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Authorized official

Name
Yan KatsnelsonNPI 1285672840
Title
Owner
Phone
(847) 774-5300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

5409 N State Road 7
Tamarac, FL 33319-2921

Mailing address

PO Box 971
Northbrook, IL 60065-0971

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1629773908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 971",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 N STATE ROAD 7",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333192921",
            "telephone_number": "847-593-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME DIALYSIS OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-774-5300"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.