Northridge Kidney Care Center LLC

Primary specialty

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

Legal business name

NORTHRIDGE KIDNEY CARE CENTER LLC

Practice address

19333 Business Center Dr
Northridge, CA 91324-3528

Phone

(818) 709-9999

NPI assigned

Sep 29, 2017

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, MDNPI 1982619359

Title

Chairman

Phone

(818) 366-4626

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Northridge Kidney Care CenterCCN 552853

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 13, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

45

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 2

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

• Vinod M Assomull Sr., MD

  • Nephrology Physician
  • Granada Hills, CA
  • NPI 1982619359
  NPD (past) Authorized official
• Julius Sumang Navarro, RDN, CSR, CNSC

  • Renal Nutrition Registered Dietitian
  • San Francisco, CA
  • NPI 1437821436
  NPD (past)

Affiliated clinicians 7

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
• Ruchika Bhasin, MD

  • Internal Medicine Physician
  • Northridge, CA
  • NPI 1215241740

  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
• Ramanath Dukkipati, M.D

  • Nephrology Physician
  • Northridge, CA
  • NPI 1457570376

  Dialysis facility

  Care Compare affiliation Name & address match
• Raghu Konanur Venkataram

  • Nephrology Physician
  • Porter Ranch, CA
  • NPI 1447538079

  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
• 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": "1506643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507852800000",
    "number": "1861901191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 COVER ST 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": "19333 BUSINESS CENTER DR",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243528",
            "telephone_number": "818-709-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHRIDGE KIDNEY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-10-13",
        "status": "A",
        "authorized_official_last_name": "ASSOMULL",
        "authorized_official_first_name": "VINOD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "818-366-4626",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northridge Family Practice Medical Group
• Northridge Free Clinic
• Northridge Golden Nest
• Northridge Home Health Inc.
• Northridge Hosptial Medical Center
• Northridge Kidney Center, LLC
• Northridge Manor
• Northridge Neurological Medical Group Inc
• Northridge Outpatient Surgery Center Inc
• Northridge Pain Management Specialists Medical Corporation

• All providers in Northridge, CA
• 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 Oct 13, 2017; 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.