NPIMap

Organization Active NPI

Vestal Healthcare, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bronx, NY
National Provider Identifier
1952768640
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
VESTAL HEALTHCARE, LLC
Practice address
1776 Eastchester Rd
2ND Floor
Bronx, NY 10461-2341
Phone
(718) 239-2089
Fax
(718) 239-2385
NPI assigned
Jan 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Authorized official

Name
Mark Caputo
Title
President
Phone
(781) 699-9000

Specialties & licenses 1

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

Addresses

Primary practice location

1776 Eastchester Rd
2ND Floor
Bronx, NY 10461-2341

Mailing address

1776 Eastchester Rd
2ND Floor
Bronx, NY 10461-2341
Phone (718) 239-2089

Other names 1

  • Freedom Center of Bronx Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New York Dialysis Services Inc48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Locations

1776 Eastchester Rd
Fl 2
Bronx, NY 10461
Phone (718) 239-2089

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1952768640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 EASTCHESTER RD",
            "address_2": "2ND FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612341",
            "telephone_number": "718-239-2089",
            "fax_number": "718-239-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 EASTCHESTER RD",
            "address_2": "2ND FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612341",
            "telephone_number": "718-239-2089",
            "fax_number": "718-239-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VESTAL HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "CAPUTO",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freedom Center of Bronx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.