San Juan Regional Kidney Care,LLC

Primary specialty

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

Legal business name

SAN JUAN REGIONAL KIDNEY CARE,LLC

Practice address

735 W Animas St Ste B
Farmington, NM 87401-5616

Phone

(505) 278-8575

Fax

(505) 787-2399

NPI assigned

Feb 28, 2022

Last updated

Mar 8, 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

Dr. Manish PandyaNPI 1326145392

Title

Provider

Phone

(505) 278-8575

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Listed as

San Juan Regional Kidney Care LLCCCN 322567

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Feb 14, 2023

Medicare certification status

ActiveFrom the Provider of Services file

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 1

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.

• Manish Pandya, M.D.

  • Nephrology Physician
  • Farmington, NM
  • NPI 1326145392
  NPD Authorized official

Affiliated clinicians 1

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

• Manish Pandya, M.D.

  • Nephrology Physician
  • Farmington, NM
  • NPI 1326145392

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1821744806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 W ANIMAS ST STE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015616",
            "telephone_number": "505-278-8575",
            "fax_number": "505-787-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 W ANIMAS ST STE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015616",
            "telephone_number": "505-278-8575",
            "fax_number": "505-787-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN REGIONAL KIDNEY CARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "PANDYA",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "505-278-8575",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "????????",
            "affiliation": "N",
            "address_1": "735 W Animas St Ste B",
            "city": "Farmington",
            "state": "NM",
            "country_code": "US",
            "postal_code": "874015616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• San Juan Miners' Association
• San Juan Nephrology
• San Juan Obstetrics & Gynecology, LLC
• San Juan Oncology Associates, PC
• San Juan Oral & Facial Surgery
• San Juan Regional Medical Center Inc (San Juan Regional Urology)
• San Juan Regional Medical Center Inc (SJRMC Surgery 1st Assists)
• San Juan Regional Medical Center Inc (San Juan Regional Cardiology)
• San Juan Regional Medical Center Inc (San Juan Pediatrics)
• San Juan Regional Medical Center Inc (SJR General Surgeons)

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Farmington, NM
• Providers in Farmington, NM by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.