Cenla Dialysis Care LLC

Primary specialty

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

Legal business name

CENLA DIALYSIS CARE LLC

Practice address

1430 W Elm St
Jena, LA 71342-4800

Phone

(318) 704-0001

NPI assigned

Jan 27, 2021

Organization subpart

No

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

Authorized official

Name

Padam Hirachan, MDNPI 1528215019

Title

Member

Phone

(646) 641-5614

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Listed as

CenLA DialysisCCN 192764

Ownership

Profit

Certified

May 17, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

3

Locations

Practitioners 3

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

• Padam Hirachan, MD

  • Nephrology Physician
  • Natchez, MS
  • NPI 1528215019

  Nephrology

  NPD Authorized official
• Khaldoun Soudan, MD

  • Nephrology Physician
  • Alexandria, LA
  • NPI 1164411815

  Nephrology

  NPD (past)
• Mark Matthew Wilson, M.D.

  • Nephrology Physician
  • Alexandria, LA
  • NPI 1295728087

  Nephrology

  NPD (past)

Affiliated clinicians 1

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

• Padam Hirachan, MD

  • Nephrology Physician
  • Natchez, MS
  • NPI 1528215019

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1871184432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 WORLEY DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013600",
            "telephone_number": "318-704-0001",
            "fax_number": "318-704-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 W ELM ST",
            "city": "JENA",
            "state": "LA",
            "postal_code": "713424800",
            "telephone_number": "318-704-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENLA DIALYSIS CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "HIRACHAN",
        "authorized_official_first_name": "PADAM",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "646-641-5614",
        "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": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Jena",
            "affiliation": "N",
            "address_1": "1430 W Elm St",
            "city": "Jena",
            "state": "LA",
            "country_code": "US",
            "postal_code": "713424800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph Buzzetta, LMSW
• Shellie Callender, PHARMACY TECH
• Deidre Carter
• Melissa Cater, BSN, RN
• Cecil C Gaddis DDS., a Professional Dental Corporation
• Chaudhry Clinic LLC
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• Riaz Masud Chaudhry, MD
• Christus Health Central Louisiana
• Christus Health Central Louisiana

• All providers in Jena, LA
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.