Woodmere Dialysis,LLC

Primary specialty

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

Legal business name

WOODMERE DIALYSIS,LLC

Practice address

121 Franklin PL
Woodmere, NY 11598-1218

Phone

(516) 374-9300

Fax

(516) 374-1786

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Bent Philipson

Title

President

Phone

(516) 374-9300

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 2

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

• Woodmere Dialysis, LLC

  dba Hamptons Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Southampton, NY
  • NPI 1861933368

  9335152917

  Same PAC ID
• Woodmere Dialysis,LLC

  dba Bay Bark Dalysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bronx, NY
  • NPI 1699318675

  9335152917

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Woodmere Dialysis, LLC

  dba Hamptons Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Southampton, NY
  • NPI 1861933368

  O20161216000649

  Same enrollment

Locations

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1750308748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 FRANKLIN PL",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981218",
            "telephone_number": "516-374-9300",
            "fax_number": "516-374-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 FRANKLIN PL",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981218",
            "telephone_number": "516-374-9300",
            "fax_number": "516-374-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODMERE DIALYSIS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "PHILIPSON",
        "authorized_official_first_name": "BENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-374-9300",
        "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": "02860979",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kennisha Wilson
• Georgene Reicher Winick
• Salayah Jashay Witcher
• Cindy Wolff, LCSW
• Siu Yin Wong, RN
• Woodmere Fire District
• Woodmere Medical Associates, P.C.
• Woodmere Ophthalmology P.C.
• Woodmere Rehabilitation and Health Care Center, Inc.
• Woodmere Speech Language Pathology PC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Woodmere, NY
• Providers in Woodmere, NY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.