Northridge Dialysis Center, LLC

Primary specialty

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

License

550001462 Issued in CA

Legal business name

NORTHRIDGE DIALYSIS CENTER, LLC

Practice address

9325 Reseda Blvd
Northridge, CA 91324-2983

Phone

(818) 993-6700

Fax

(818) 993-6711

NPI assigned

Feb 8, 2010

Organization subpart

No

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

Authorized official

Name

Vinod M Assomull, M.D.

Title

Owner

Phone

(818) 321-5800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Northridge Dialysis CenterCCN 552674

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Apr 6, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Other

Dialysis stations

22

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Sohan L. Dua M.D.

  dba Valley Renal Medical Group

  • Specialist
  • Northridge, CA
  • NPI 1215149026

  Member Of

  NPD member

Locations

Affiliated clinicians 5

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

• Brian Barrios Ayuste, M.D.

  • Internal Medicine Physician
  • Granada Hills, CA
  • NPI 1104003458

  Dialysis facility

  Care Compare affiliation Name & address match
• Anant J Desai, MD

  • Nephrology Physician
  • Granada Hills, CA
  • NPI 1871500389

  Dialysis facility

  Care Compare affiliation Name & address match
• Kalyani Nilesh Mehta, MD

  • Nephrology Physician
  • Granada Hills, CA
  • NPI 1699899724

  Dialysis facility

  Care Compare affiliation Name & address match
• Sohail Nasim, M.D.

  • Nephrology Physician
  • West Hills, CA
  • NPI 1174623920

  Dialysis facility

  Care Compare affiliation Name & address match
• Balbir Singh, M.D.

  • Nephrology Physician
  • Van Nuys, CA
  • NPI 1114013927

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1801128301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 COVER ST",
            "address_2": "STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081790",
            "telephone_number": "562-421-2690",
            "fax_number": "562-421-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9325 RESEDA BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913242983",
            "telephone_number": "818-993-6700",
            "fax_number": "818-993-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHRIDGE DIALYSIS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-08",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "ASSOMULL",
        "authorized_official_first_name": "VINOD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-321-5800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "550001462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801128301",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northridge Boarding Care
• Northridge Center Pharmacy
• Northridge Community Boarding Care, Inc.
• Northridge Counseling Center
• Northridge Dermatology Associates Medical Group Inc
• Northridge Emergency Medical Group
• Northridge Facial Plastic Surgery Medical Group a Professional Corp
• Northridge Family Practice
• Northridge Family Practice Medical Group
• Northridge Free Clinic

• 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 Nov 29, 2016; 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.