Woodmere Dialysis, LLC

Primary specialty

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

Legal business name

WOODMERE DIALYSIS, LLC

Practice address

64 County Road 39
Southampton, NY 11968-5215

Phone

(631) 702-1000

NPI assigned

Mar 16, 2017

Organization subpart

No

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

Authorized official

Name

Bent Philipson

Title

President

Phone

(516) 374-9300

Specialties & licenses 1

Addresses

Other names 1

• Hamptons Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Woodmere Dialysis,LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bronx, NY
  • NPI 1699318675

  9335152917

  Same PAC ID
• Woodmere Dialysis,LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Woodmere, NY
  • NPI 1750308748

  9335152917

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Woodmere Dialysis,LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Woodmere, NY
  • NPI 1750308748

  O20161216000649

  Same enrollment

Listed as

Hamptons Dialysis CenterCCN 332760

Ownership

Profit

Certified

May 31, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

9

Tax ID family

Bay Bark Dalysis Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Woodmere Dialysis,LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bronx, NY
  • NPI 1699318675
  NPD tax ID

Locations

Affiliated clinicians 3

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

• Amy Elizabeth Dalton, DO

  • Nephrology Physician
  • Southampton, NY
  • NPI 1144742917

  Dialysis facility

  Care Compare affiliation Name & address match
• Louis Ronald Spiegel, M.D.

  • Nephrology Physician
  • Southampton, NY
  • NPI 1821230715

  Dialysis facility

  Care Compare affiliation Name & address match
• Gaylord Thomas Hoffert, MD

  • Nephrology Physician
  • Pinehurst, NC
  • NPI 1447235965

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1861933368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 FRANKLIN PL",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981218",
            "telephone_number": "516-374-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 COUNTY ROAD 39",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685215",
            "telephone_number": "631-702-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODMERE DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "PHILIPSON",
        "authorized_official_first_name": "BENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-374-9300"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hamptons Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jerome R Weiner, MD
• Barbra Weitz
• Jason J Westra, CRNA
• Lauren Marie Whitney
• Darin Gregory Wiggins, MD
• Edward Wormold, PTA
• Alexander Wright, PSYD
• Lewis William Wright, D.D.S.
• Brenden Raymond Yee, D.O.
• Kayla Nazila Zafar, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Southampton, NY
• Providers in Southampton, 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 Mar 16, 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.