Avy, LLC

Primary specialty

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

Legal business name

AVY, LLC

Practice address

1510 S Central Ave Ste 140
Glendale, CA 91204-3857

Phone

(310) 467-5197

NPI assigned

Mar 16, 2021

Organization subpart

No

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

Authorized official

Name

Andrey Tarasov

Title

Member/Manager

Phone

(310) 467-5197

Specialties & licenses 1

Addresses

Other names 1

• Care Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Care Dialysis CenterCCN 752549

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Apr 29, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

11

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 2

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

• Roderick A Comunale II, MD

  • Nephrology Physician
  • National City, CA
  • NPI 1568462109

  Dialysis facility

  Care Compare affiliation Name & address match
• David Sherman, M.D.

  • Specialist
  • Glendale, CA
  • NPI 1235164294

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618617600000",
    "number": "1649855297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 S CENTRAL AVE STE 140",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043857",
            "telephone_number": "310-467-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S CENTRAL AVE STE 140",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043857",
            "telephone_number": "310-467-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-04-17",
        "certification_date": "2021-04-17",
        "status": "A",
        "authorized_official_last_name": "TARASOV",
        "authorized_official_first_name": "ANDREY",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "310-467-5197"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Care Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Care Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Avo Transport Inc
• Tanya Avoyan, LMFT
• Rodrik Avrand
• Avs Pharmacy Inc
• Avs Pharmacy Inc
• Axiograft
• Axoderm Corp
• Candelaria Ayala, DDS
• Rezinka Ayala
• Sebastian Ayala

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2021; 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.