Mills Pond Dialysis Center, LLC

Primary specialty

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

Legal business name

MILLS POND DIALYSIS CENTER, LLC

Doing business as

Cassena Kidney Care at East Neck

Practice address

134 Great East Neck Rd
West Babylon, NY 11704-8027

Phone

(516) 422-4800

NPI assigned

Nov 24, 2014

Organization subpart

No

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

Authorized official

Name

Pasquale Debenedictis

Title

Manager / Member

Phone

(516) 422-7818

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cassena Kidney Care at East Neck Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Listed as

Cassena Kidney Care at East NeckCCN 332731

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Sep 11, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

11

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 3

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

• Ralph T Barbato, D.O.

  • Nephrology Physician
  • Bay Shore, NY
  • NPI 1184725236

  Dialysis facility

  Care Compare affiliation Name & address match
• Victor Chang, M.D.

  • Nephrology Physician
  • Bethpage, NY
  • NPI 1558537191

  Dialysis facility

  Care Compare affiliation Name & address match
• William M Frank, M.D.

  • Nephrology Physician
  • Bay Shore, NY
  • NPI 1972604007

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1962809632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 GREAT EAST NECK RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117048027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 GREAT EAST NECK RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117048027",
            "telephone_number": "516-422-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLS POND DIALYSIS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-24",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "DEBENEDICTIS",
        "authorized_official_first_name": "PASQUALE",
        "authorized_official_title_or_position": "MANAGER / MEMBER",
        "authorized_official_telephone_number": "516-422-7818"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "332731",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cassena Kidney Care at East Neck",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Polcino MD PC
• Richard W Michaelis, DDS
• Robert L Michaels, MD
• Patricia Milizio, LCSW-R
• Mitchell Howard Miller, R.PH.
• Roseann Milner
• Jennifer Mingione, M.D.
• Lauren Misuraca, FNP
• Valerie Mitchelson Jasmin
• Ross Francis Mittiga, CPO

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in West Babylon, NY
• Providers in West Babylon, NY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.