Green Manor Dialysis Center LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

1059202R Issued in NY

Legal business name

GREEN MANOR DIALYSIS CENTER LLC

Doing business as

Northern Hudson Valley Dialysis Center

Practice address

159 Jefferson HTS
Catskill, NY 12414-1237

Phone

(518) 943-1404

Fax

(518) 943-2602

NPI assigned

Sep 1, 2005

Last updated

Jul 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vinny Anand, MD

Title

Ceo Medical Director

Phone

(518) 943-1404

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northern Hudson Valley Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Green Manor Dialysis Center LLC

  dba DBA Columbia-Greene Dialysis Centers

  • Clinic/Center
  • Ghent, NY
  • NPI 1467445601

  7315854064

  Same PAC ID

Listed as

Columbia-Greene Dialysis (Catskill Division)CCN 332641

Overall star rating

1.0 of 5

Ownership

Profit

Certified

May 1, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

24

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

CLIA laboratory certificates

Tax ID family

Green Manor Dialysis Center LLC2 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.

• Green Manor Dialysis Center LLC

  dba DBA Columbia-Greene Dialysis Centers

  • Clinic/Center
  • Ghent, NY
  • NPI 1467445601
  NPD tax ID

Affiliated clinicians 1

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

• Vinny Anand, M.D.

  • Nephrology Physician
  • Hudson, NY
  • NPI 1336195510

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1912991266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 JEFFERSON HTS",
            "city": "CATSKILL",
            "state": "NY",
            "postal_code": "124141237",
            "telephone_number": "518-943-1404",
            "fax_number": "518-943-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 JEFFERSON HTS",
            "city": "CATSKILL",
            "state": "NY",
            "postal_code": "124141237",
            "telephone_number": "518-943-1404",
            "fax_number": "518-943-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN MANOR DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-01",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "ANAND",
        "authorized_official_first_name": "VINNY",
        "authorized_official_title_or_position": "CEO MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "518-943-1404",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "1059202R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01687094",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Hudson Valley Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Antonio Gomez Jr., RN
• Myrna Doris Gonzalez, M.A.CCC-SLP
• Necole Renee Good, P.T.
• Diane Lynn Gotebiowski, P.T.
• Matthew P Grassi, RPH
• Greene County Public Health
• Greene County Public Health
• Greene County Public Health
• Greene Medical Arts Pharmacy
• Greene Medical Imaging PC

• Clinic/Center in Catskill, NY
• Providers in Catskill, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.