Organization Active NPI

Saint Elizabeth Medical Center Dialysis Unit

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brighton, MA
National Provider Identifier
1881801868
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SAINT ELIZABETH MEDICAL CENTER DIALYSIS UNIT
Practice address
736 Cambridge St
Brighton, MA 02135-2907
Phone
(800) 664-3884
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David Oslund
Title
Billing Manager
Phone
(800) 664-3884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

736 Cambridge St
Brighton, MA 02135-2907

Mailing address

PO Box 50664
Woburn, MA 01815-0001
Phone (800) 664-3884

Other identifiers 1

IdentifierTypeStateIssuer
1201719MedicaidMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881801868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50664",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018150001",
            "telephone_number": "800-664-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "800-664-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ELIZABETH MEDICAL CENTER DIALYSIS UNIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OSLUND",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "800-664-3884",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "1201719",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.