Medi-System Renal Care Management Services LLC

Primary specialty

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

License

202469 Issued in NY

Legal business name

MEDI-SYSTEM RENAL CARE MANAGEMENT SERVICES LLC

Doing business as

hollis dialysis

Practice address

18230 Jamaica Ave
Hollis, NY 11423-2328

Phone

(516) 473-3762

NPI assigned

Jun 30, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Garaudy Roger Antoine

Title

President / Administrator

Phone

(516) 473-3762

Specialties & licenses 1

Addresses

Other names 1

• hollis dialysis Doing business as

Locations

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

{
    "created_epoch": "1372550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372550400000",
    "number": "1811337256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18230 JAMAICA AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232328",
            "telephone_number": "516-473-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18230 JAMAICA AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232328",
            "telephone_number": "516-473-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI-SYSTEM RENAL CARE MANAGEMENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-30",
        "last_updated": "2013-06-30",
        "status": "A",
        "authorized_official_last_name": "ANTOINE",
        "authorized_official_first_name": "GARAUDY",
        "authorized_official_middle_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT / ADMINISTRATOR",
        "authorized_official_telephone_number": "516-473-3762",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "202469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "hollis dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamie Masterson
• Shawn Kakkathottathil Mathew, DO
• Thomas Mathew, LMSW
• Necola Mayers
• Dona Marcia McEwan, LPN
• Kourosh Mehrnia, DDS
• Nazanin Mehrnia, DDS
• Menahal Begawala
• Amy B. Meyer, D.O.
• Paul Meyeroff, RPH

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Hollis, NY
• Providers in Hollis, 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 Jun 30, 2013; 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.