Evn Dialysis Center, LLC

Primary specialty

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

Legal business name

EVN DIALYSIS CENTER, LLC

Practice address

18040 Sherman Way Ste 100
Reseda, CA 91335-4656

Phone

(818) 457-3949

Fax

(818) 609-0076

NPI assigned

Aug 27, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Gunda Jahromi

Title

Partner

Phone

(818) 457-3949

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

EVN Dialysis CenterCCN 752529

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Jun 4, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

21

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Kaveh Sharif, M.D.

  • Nephrology Physician
  • Beverly Hills, CA
  • NPI 1366465825
  NPD (past)

Affiliated clinicians 5

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

• Alan Fozailoff, M.D.

  • Nephrology Physician
  • Tarzana, CA
  • NPI 1053331595

  Dialysis facility

  Care Compare affiliation Name & address match
• Hooman Kashani, DO

  • Nephrology Physician
  • Encino, CA
  • NPI 1124117452

  Dialysis facility

  Care Compare affiliation Name & address match
• Kalpesh Patel, M.D.

  • Nephrology Physician
  • Calabasas, CA
  • NPI 1902099146

  Dialysis facility

  Care Compare affiliation Name & address match
• Jacob Poulose, MD.

  • Nephrology Physician
  • Northridge, CA
  • NPI 1578723508

  Dialysis facility

  Care Compare affiliation Name & address match
• Eyal Shtorch, MD

  • Nephrology Physician
  • Reseda, CA
  • NPI 1942395603

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1962050757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18040 SHERMAN WAY STE 100",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354656",
            "telephone_number": "818-457-3949",
            "fax_number": "818-609-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18040 SHERMAN WAY STE 100",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354656",
            "telephone_number": "818-457-3949",
            "fax_number": "818-609-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVN DIALYSIS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-27",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "JAHROMI",
        "authorized_official_first_name": "GUNDA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "818-457-3949",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "001",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@statewidere.net",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "18040 Sherman Way",
            "city": "Reseda",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913354631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CONTACT@STATEWIDERE.NET",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMAIL",
            "address_1": "18040 Sherman Way",
            "city": "Reseda",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913354631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gunda@evndialysis.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "18040 Sherman Way Ste 100",
            "city": "Reseda",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913354656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Reseda, CA
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.