St Joseph'S Dialysis

Primary specialty

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

Legal business name

ST JOSEPH'S DIALYSIS

Practice address

3993 West Rd
Cortland, NY 13045-1843

Phone

(607) 662-0140

Fax

(607) 662-0519

NPI assigned

Jan 12, 2007

Organization subpart

Yes

Parent organization

ST JOSEPHS HOSPITAL HEALTH CENTERAs reported in NPPES

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

Authorized official

Name

Mark Waite

Title

Director

Phone

(315) 703-6777

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• CORTLAND DIALYSIS Other name

Tax ID family

Ability Network6 organizations share this tax ID, including this one

Part of

Sally Klemens MD

Other organizations with this tax ID 5

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

• SJLS, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fayetteville, NY
  • NPI 1174760573
  NPD tax ID
• SJLS, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cortland, NY
  • NPI 1235376633
  NPD tax ID
• SJLS, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Camillus, NY
  • NPI 1548407943
  NPD tax ID
• SJLS, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Syracuse, NY
  • NPI 1619114014
  NPD tax ID
• SJLS, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Liverpool, NY
  • NPI 1972740371
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  NPPES parent name

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248998400000",
    "number": "1831249440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "973 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032524",
            "telephone_number": "315-703-6700",
            "fax_number": "315-703-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3993 WEST RD",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451843",
            "telephone_number": "607-662-0140",
            "fax_number": "607-662-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH'S DIALYSIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST JOSEPHS HOSPITAL HEALTH CENTER",
        "enumeration_date": "2007-01-12",
        "last_updated": "2009-07-31",
        "status": "A",
        "authorized_official_last_name": "WAITE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "315-703-6777"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02995893",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00315013",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORTLAND DIALYSIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christopher T. Sorvari, PHARMD
• Wesley Spagnuolo, DPT
• Megan Speer, MSW
• Virginia Skoros Spiers, LMSW
• Mitchell Spindler, DPT
• Jacquelyn Rae Staggs
• Pamela Ann Stanton, RN
• Kelly Lynn Stark, LPN
• Alexandra Starmer, LMHC
• State of New York Comptrollers Office

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Cortland, NY
• Providers in Cortland, 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 Jul 31, 2009; 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.