Northridge Kidney Center, LLC

Primary specialty

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

Legal business name

NORTHRIDGE KIDNEY CENTER, LLC

Practice address

17710 Roscoe Blvd
Northridge, CA 91325-3910

Phone

(818) 739-4888

Fax

(747) 265-6106

NPI assigned

May 23, 2019

Last updated

Jun 7, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Parag Shah, MDNPI 1225020886

Title

Medical Director

Phone

(818) 365-1194

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Northridge Kidney Center, LLCCCN 552879

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Nov 18, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

24

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Parag Arvind Shah, M.D

  • Nephrology Physician
  • Mission Hills, CA
  • NPI 1225020886
  Authorized official Same address or phone
• Omaran A Abdeen, M.D.

  • Nephrology Physician
  • Mission Hills, CA
  • NPI 1700878410
  NPD
• Michelle Juan, RN

  • Registered Nurse
  • Northridge, CA
  • NPI 1043075799
  NPD
• Ammar Alnaser, M.D.

  • Nephrology Physician
  • Mission Hills, CA
  • NPI 1073909370
  NPD (past)

Affiliated clinicians 6

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

• Omaran A Abdeen, M.D.

  • Nephrology Physician
  • Mission Hills, CA
  • NPI 1700878410

  Dialysis facility

  Care Compare affiliation Name & address match
• Ammar Alnaser, M.D.

  • Nephrology Physician
  • Mission Hills, CA
  • NPI 1073909370

  Dialysis facility

  Care Compare affiliation Name & address match
• Pascal Dabel, M.D.

  • Nephrology Physician
  • Mission Hills, CA
  • NPI 1033306592

  Dialysis facility

  Care Compare affiliation Name & address match
• Billy Try Hour, M.D.

  • Hospitalist Physician
  • Mission Hills, CA
  • NPI 1790097004

  Dialysis facility

  Care Compare affiliation Name & address match
• Anthony Paul Nicolaysen, MD

  • Nephrology Physician
  • Mission Hills, CA
  • NPI 1154869576

  Dialysis facility

  Care Compare affiliation Name & address match
• Parag Arvind Shah, M.D

  • Nephrology Physician
  • Mission Hills, CA
  • NPI 1225020886

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1790342897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23421 LYONS AVE",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913553028",
            "telephone_number": "818-903-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17710 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913253910",
            "telephone_number": "818-739-4888",
            "fax_number": "747-265-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHRIDGE KIDNEY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-23",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "PARAG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-365-1194",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northridge Free Clinic
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• Northridge Home Health Inc.
• Northridge Hosptial Medical Center
• Northridge Kidney Care Center LLC
• Northridge Manor
• Northridge Neurological Medical Group Inc
• Northridge Outpatient Surgery Center Inc
• Northridge Pain Management Specialists Medical Corporation
• Northridge Physical Therapy Center,Inc

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Northridge, CA
• Providers in Northridge, 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 Jun 7, 2022; 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.