NPIMap

Organization Active NPI

Island Rehabilitative Services Corp.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Commack, NY
National Provider Identifier
1679768634
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
ISLAND REHABILITATIVE SERVICES CORP.
Practice address
68 Hauppauge Rd
Commack, NY 11725-4403
Phone
(718) 448-5641
Fax
(718) 448-6117
NPI assigned
Sep 12, 2007
Last updated
May 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Authorized official

Name
Dr. Morton Kleiner, MD
Title
President
Phone
(718) 987-5942

Specialties & licenses 1

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

Addresses

Primary practice location

68 Hauppauge Rd
Commack, NY 11725-4403

Mailing address

97 New Dorp LN
Staten Island, NY 10306-2359
Phone (718) 448-5641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071023000295 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 7810808003 Practice locations: Commack, NY

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Island Rehabilitative Services - Commack DialysisCCN 332663
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Jan 26, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
12

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

National Provider Directory

National Provider Directory
Tax ID family
Island Rehabilitative Servicesbronx3 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.

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1679768634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 NEW DORP LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062359",
            "telephone_number": "718-448-5641",
            "fax_number": "718-876-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 HAUPPAUGE RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254403",
            "telephone_number": "718-448-5641",
            "fax_number": "718-448-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND REHABILITATIVE SERVICES CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "KLEINER",
        "authorized_official_first_name": "MORTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-987-5942",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.