NPIMap

Organization Active NPI

Midwood Chayim Aruchim Dialysis Associates, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1730409301
Registry record updated Jun 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
MIDWOOD CHAYIM ARUCHIM DIALYSIS ASSOCIATES, INC
Doing business as
4102-13th Avenue Management, LLC
Practice address
4102 13TH Ave
Brooklyn, NY 11219-1333
Phone
(718) 517-2222
NPI assigned
Jun 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2010

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

Authorized official

Name
Mr. Michael Shtern
Title
Administrator, Ceo
Phone
(718) 258-7700

Specialties & licenses 1

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

Addresses

Primary practice location

4102 13TH Ave
Brooklyn, NY 11219-1333

Mailing address

1915 Ocean Ave
Brooklyn, NY 11230-6801
Phone (718) 258-7700

Other identifiers 1

IdentifierTypeStateIssuer
02002642MedicaidNY

Other names 1

  • 4102-13th Avenue Management, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Knickerbocker Dialysis Inc65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1275868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275868800000",
    "number": "1730409301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306801",
            "telephone_number": "718-258-7700",
            "fax_number": "718-258-9273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112191333",
            "telephone_number": "718-517-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWOOD CHAYIM ARUCHIM DIALYSIS ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-07",
        "last_updated": "2010-06-07",
        "status": "A",
        "authorized_official_last_name": "SHTERN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR, CEO",
        "authorized_official_telephone_number": "718-258-7700",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "02002642",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4102-13th Avenue Management, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; 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.