Capital Region Dialysis Clinic LLC

Primary specialty

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

Legal business name

CAPITAL REGION DIALYSIS CLINIC LLC

Practice address

1051 Brightseat Road
Landover, MD 20785

Phone

(410) 766-1995

NPI assigned

Jan 31, 2018

Organization subpart

No

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

Authorized official

Name

Brian Finglass, CPA

Title

Cfo

Phone

(410) 766-1995

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Listed as

Capital Region Dialysis Clinic LLCCCN 212729

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Jun 14, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

9

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Affiliated clinicians 5

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

• Karen De Castro Dah, M.D.

  • Nephrology Physician
  • Salisbury, MD
  • NPI 1730467804

  Dialysis facility

  Care Compare affiliation Name & address match
• Ziad Khoury, M.D.

  • Nephrology Physician
  • Chevy Chase, MD
  • NPI 1285075218

  Dialysis facility

  Care Compare affiliation Name & address match
• Nirmala Yadla, MD

  • Nephrology Physician
  • Greenbelt, MD
  • NPI 1437266624

  Dialysis facility

  Care Compare affiliation Name & address match
• Oyije Susan Iheagwara, MD

  • Nephrology Physician
  • Washington, DC
  • NPI 1174705149

  Dialysis facility

  Care Compare affiliation Name & address match
• Antonina Y Kolesnikova, MD

  • Nephrology Physician
  • Washington, DC
  • NPI 1598932592

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1902304371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8028 RITCHIE HWY STE 210",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211221075",
            "telephone_number": "410-766-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 BRIGHTSEAT ROAD",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "20785",
            "telephone_number": "410-766-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION DIALYSIS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "FINGLASS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "410-766-1995",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Azizsani Calloway
• Denyce Calloway, PH.D.
• Jacqueline Suzette Canada, HHA
• Capital Care Anesthesia LLC
• Capital Care Clinic LLC
• Paola Caraballo Jimenez
• Care Connection Inc
• Zyriyah Carey
• Danae Carney
• Jasmine Carney

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Landover, MD
• Providers in Landover, MD by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.