NPIMap

Organization Active NPI

Avantus Renal Therapy New York, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New York, NY
National Provider Identifier
1811329162
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
AVANTUS RENAL THERAPY NEW YORK, LLC
Practice address
120 E 16TH St FL 6
New York, NY 10003-2162
Phone
(646) 602-6950
Fax
(646) 602-6956
NPI assigned
Aug 8, 2013
Organization subpart
Yes
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Barry L. Blanton
Title
Vice President
Phone
(781) 699-9000

Specialties & licenses 1

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

Addresses

Primary practice location

120 E 16TH St FL 6
New York, NY 10003-2162

Mailing address

120 E 16TH St FL 6
New York, NY 10003-2162
Phone (646) 602-6950

Other names 1

  • AVANTUS IRVING PLACE DIALYSIS CENTER Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131024001896 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 4486891066 Practice locations: New York, NY

Other NPIs with the same Medicare PAC ID 3

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1001763Avantus Irving Place Dialysis Center120 E 16TH St - 6TH Floor, New York, NY 10003Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ability Network4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2465 Broadway
#3
New York, NY 10025
Phone (212) 501-8100

488 W 128th St
New York, NY 10027
Phone (212) 666-3904

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1811329162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E 16TH ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032162",
            "telephone_number": "646-602-6950",
            "fax_number": "646-602-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 16TH ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032162",
            "telephone_number": "646-602-6950",
            "fax_number": "646-602-6956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTUS RENAL THERAPY NEW YORK, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2013-08-08",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "BLANTON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "AVANTUS IRVING PLACE DIALYSIS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.