Simeon Dialysis LLC

Primary specialty

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

License

24472 Issued in NJ

Legal business name

SIMEON DIALYSIS LLC

Practice address

703 Main St
Paterson, NJ 07503-2621

Phone

(973) 754-3570

Fax

(973) 754-2882

NPI assigned

Dec 12, 2011

Organization subpart

No

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

Authorized official

Name

Samuel Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St Josephs SJRMC Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Simeon Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Wayne, NJ
  • NPI 1205104841

  9537336334

  Same PAC ID
• Simeon Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Paterson, NJ
  • NPI 1871862730

  9537336334

  Same PAC ID

Listed as

DaVita St. Joseph's SJRMC DialysisCCN 312613

Ownership

Profit

Certified

Dec 1, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

8

Tax ID family

Simeon Dialysis LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Simeon Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Wayne, NJ
  • NPI 1205104841
  NPD tax ID
• St. Joseph'S Dialysis , LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Wayne, NJ
  • NPI 1407183940
  NPD tax ID

Member of 2

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

• St Joseph'S Hospital and Medical Center

  • Rehabilitation Hospital Unit
  • Wayne, NJ
  • NPI 1609847870

  Member Of

  NPD member
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Castle Rock, CO
  • NPI 1386928430

  Member Of

  NPD member

Affiliated clinicians 1

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

• Vipulkumar M. Bhalara, MD

  • Nephrology Physician
  • Wayne, NJ
  • NPI 1942676267

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1639447105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-3570",
            "fax_number": "973-754-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMEON DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NJ",
            "license": "24472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0302091",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Josephs SJRMC Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Josephs SJRMC Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Olivia Silloca Cabana, MD
• Gray R Silva
• Lesly Silva
• Waldemar Emilio Silva, MD
• Mallory Simchick, PHARM.D.
• Simeon Dialysis LLC
• Aneekah G Simmons-Durham, PA
• Amanda Lauren Simon, DO
• Marc Edward Simon, D.D.S.
• Simple Smiles LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Paterson, NJ
• Providers in Paterson, 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 Apr 21, 2025; 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.