KNICKERBOCKER DIALYSIS INC (NPI# 1013410133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013410133 |
| Entity Type | Organization |
| Organization Name | KNICKERBOCKER DIALYSIS INC |
| Other Organization Name | UNIVERSITY HEIGHTS DIALYSIS |
| Practice Address |
2190 Jerome Ave Bronx NY 10453-1815 |
| Mailing Address |
5200 Virginia Way L and C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 7185845746 |
| Practice Fax Number | 7185842106 |
| Mailing Telephone | 6153204414 |
| Mailing Fax Number | 8668652884 |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |
| Authorized Official Name | JAMES HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 6153204414 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| University Heights Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043839269 | Knickerbocker Dialysis Inc | Clinic/Center | 5518 Avenue N, Brooklyn, NY 11234-4006 | 2020-04-09 |
| 1679192876 | Knickerbocker Dialysis Inc | Clinic/Center | 1734 Hancock St, Ridgewood, NJ 11385-4734 | 2020-04-09 |
| 1942839378 | Knickerbocker Dialysis Inc | Clinic/Center | 479 E Main St, Patchogue, NY 11772-3147 | 2020-04-07 |
| 1205461639 | Knickerbocker Dialysis Inc | Clinic/Center | 1277 Middle Country Rd, Middle Island, NY 11953 | 2020-03-05 |
| 1629617576 | Knickerbocker Dialysis Inc | Clinic/Center | 1633 Route 202 Ste 120, Pomona, NY 10970-2926 | 2019-12-24 |
| 1740824184 | Knickerbocker Dialysis Inc | Clinic/Center | 11 Romaine Ave, Yonkers, NY 10705 | 2019-10-29 |
| 1902456742 | Knickerbocker Dialysis Inc | Clinic/Center | 34 Marconi St Ste 110, Bronx, NY 10461-2755 | 2019-09-13 |
| 1386205714 | Knickerbocker Dialysis Inc | Clinic/Center | 860 Grand Blvd, Deer Park, NY 11729-5706 | 2019-06-26 |
| 1407415243 | Knickerbocker Dialysis Inc | Clinic/Center | 931 Bruckner Blvd, Bronx, NY 10459-4525 | 2019-06-06 |
| 1306404926 | Knickerbocker Dialysis Inc | Clinic/Center | 203 W Route 59, Nanuet, NY 10954-2218 | 2019-05-29 |
| Street Address |
2190 JEROME AVE |
| City | BRONX |
| State | NY |
| Zip Code | 10453-1815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553225 | Victor Felipe | Occupational Therapist | 2042 Grand Avenue, Apartment 2d, Ny, Apt 2d, Bronx, NY 10453 | 2020-09-17 |
| 1033745849 | Jennifer Vargas | Student in an Organized Health Care Education/Training Program | Bronxcare Health Systems Dept of Dentistry, 1775 Grand Concourse 6th Floor, Bronx, NY 10453 | 2020-03-13 |
| 1457985038 | John Steven Contreras | Student in an Organized Health Care Education/Training Program | Bronxcare Health Systems, Dept of Dentistry, 1775 Grand Concourse 6th Floor, Bronx, NY 10453 | 2020-02-24 |
| 1538799648 | Ari Warshawsky | Counselor | Postgraduate Center for Mental Health, 1775 Grand Concourse, 8th Floor, Bronx, NY 10453 | 2020-01-17 |
| 1407403413 | Cristaly Williams | Behavioral Analyst | 2105 Jerome Avenue, Bronx, NY 10453 | 2019-08-23 |
| 1770041204 | Yei Won Lee | Student in an Organized Health Care Education/Training Program | Bronxcare Health Systems, Dental Dept, 1775 Grand Concourse, 6th Floor, Bronx, NY 10453 | 2019-03-04 |
| 1265905517 | William Alexander Jones Jr. | Behavior Technician | 1749grand Concourse, 1749 Grand Concourse Apt Ph8, Bronx, NY 10453 | 2019-01-09 |
| 1154810737 | Emily Patricia Mitchell | Occupational Therapist | 2105 Jerome Ave, Bronx, NY 10453 | 2018-05-09 |
| 1417445149 | Ashna N Shah | Student in an Organized Health Care Education/Training Program | Bronx Lebanon Hospital Center 6 Th Floor, 1775 Grand Concourse, Bronx, NY 10453 | 2018-04-27 |
| 1700384328 | Kevin Ponce Obate | Physical Therapist | 1975 University Ave, Bronx, NY 10453 | 2018-01-29 |
| Find all providers in zip 10453 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326678111 | New York Dialysis Services, Inc | Clinic/Center | 794 St Anns Ave, Bronx, NY 10456 | 2020-01-21 |
| 1902456742 | Knickerbocker Dialysis Inc | Clinic/Center | 34 Marconi St Ste 110, Bronx, NY 10461-2755 | 2019-09-13 |
| 1407415243 | Knickerbocker Dialysis Inc | Clinic/Center | 931 Bruckner Blvd, Bronx, NY 10459-4525 | 2019-06-06 |
| 1700353943 | New York Dialysis Services Inc | Clinic/Center | 1776 Eastchester Rd Ste 240, Bronx, NY 10461-2335 | 2018-10-25 |
| 1730676743 | Knickerbocker Dialysis Inc | Clinic/Center | 1820 E Tremont Ave, Bronx, NY 10460-3131 | 2018-04-16 |
| 1063911659 | Knickerbocker Dialysis Inc | Clinic/Center | 1490 Macombs Rd, Bronx, NY 10452-2101 | 2018-02-08 |
| 1275032856 | Knickerbocker Dialysis Inc | Clinic/Center | 2554 White Plains Rd, Bronx, NY 10467-8141 | 2018-02-08 |
| 1063932945 | Knickerbocker Dialysis Inc | Clinic/Center | 3440 Boston Rd, Bronx, NY 10469-2512 | 2017-06-22 |
| 1962957993 | Knickerbocker Dialysis Inc | Clinic/Center | 2331 Eastchester Rd, Bronx, NY 10469-5910 | 2016-08-19 |
| 1033582283 | Usrc Pelham, LLC | Clinic/Center | 1225a Morris Park Ave, Bronx, NY 10461-1929 | 2015-11-10 |
| Find all providers in BRONX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.