NPIMap

Organization Active NPI

Genesis Services, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Glendale, NY
National Provider Identifier
1962888560
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
7003284R Issued in NY
Legal business name
GENESIS SERVICES, LLC
Practice address
7407 88TH St
Glendale, NY 11385-7951
Phone
(646) 931-1000
NPI assigned
Aug 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Authorized official

Name
Nathan Brachfeld
Title
Member
Phone
(800) 975-5201

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 7003284R NY Primary

Addresses

Primary practice location

7407 88TH St
Glendale, NY 11385-7951

Mailing address

7407 88TH St
Glendale, NY 11385-7951
Phone (646) 931-1000

Other names 1

  • Genesis Renal Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151016001385 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 9335458280 Practice locations: Glendale, NY

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Genesis Services 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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1962888560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7407 88TH ST",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857951",
            "telephone_number": "646-931-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7407 88TH ST",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857951",
            "telephone_number": "646-931-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-05",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "BRACHFELD",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "800-975-5201"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "7003284R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Renal Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.