NPIMap

Organization Active NPI

Personal Dialysis, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brighton, MA
National Provider Identifier
1902907652
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
EQZF Issued in MA
Legal business name
PERSONAL DIALYSIS, INC.
Practice address
747 Cambridge St
Brighton, MA 02135-2926
Phone
(617) 783-3800
Fax
(617) 783-0255
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Martin L. Gelman, M.D.NPI 1093705725
Title
President
Phone
(781) 932-8891

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

747 Cambridge St
Brighton, MA 02135-2926

Mailing address

400 W Cummings Park
Suite 2250
Woburn, MA 01801-6519
Phone (781) 932-8891

Other identifiers 3

IdentifierTypeStateIssuer
93942OtherMAFALLON HEALTHCARE PROV NO
AA33419OtherMAHPHC PAYEE ID
1316303MedicaidMA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1902907652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W CUMMINGS PARK",
            "address_2": "SUITE 2250",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016519",
            "telephone_number": "781-932-8891",
            "fax_number": "617-783-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 CAMBRIDGE ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352926",
            "telephone_number": "617-783-3800",
            "fax_number": "617-783-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL DIALYSIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GELMAN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-932-8891",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MA",
            "license": "EQZF",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON HEALTHCARE PROV NO",
            "identifier": "93942",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC PAYEE ID",
            "identifier": "AA33419",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316303",
            "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 Jul 21, 2022; 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.