PRODIGY DIALYSIS (NPI# 1043393440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043393440 |
| Entity Type | Organization |
| Organization Name | PRODIGY DIALYSIS |
| Practice Address |
105 Metzler St Johnstown PA 15904-3124 |
| Practice Telephone | 8145390798 |
| Practice Fax Number | 8145364751 |
| Mailing Telephone | 8145390798 |
| Mailing Fax Number | 8145364751 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2013-02-05 |
| Authorized Official Name | DR. GEORGE JOSEPH FREM (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8145390798 |
| Authorized Official Credential | MD |
| 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 |
MD042825E | PA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417191404 | Prodigy Dialysis | Clinic/Center | 25 Center St, Meyersdale, PA 15552-1101 | 2009-04-22 |
| 1851645840 | Prodigy Dialysis | Clinic/Center | 211 Thompson St, Seward, PA 15954-2053 | 2012-10-30 |
| 1902170525 | Prodigy Dialysis | Clinic/Center | 387 Theatre Rd, Carrolltown, PA 15722-7805 | 2012-02-29 |
| 1811261431 | Prodigy Dialysis | Clinic/Center | 119 Spring Ln, Everett, PA 15537-6938 | 2012-02-29 |
| 1811131790 | Prodigy Dialysis | Clinic/Center | 211 Georgian Pl, Somerset, PA 15501-1610 | 2009-04-23 |
| 1811131782 | Prodigy Dialysis | Clinic/Center | 88 Osborne St, Johnstown, PA 15905-4146 | 2009-04-23 |
| 1184868051 | Prodigy Dialysis | Clinic/Center | 1100 W High St, Ebensburg, PA 15931-1706 | 2009-04-23 |
| 1023065554 | Prodigy Dialysis | Clinic/Center | 1111 Franklin St, Suite 220, Johnstown, PA 15905-4330 | 2006-05-29 |
| Street Address |
105 METZLER ST |
| City | JOHNSTOWN |
| State | PA |
| Zip Code | 15904-3124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518506989 | Dialcare Dialysis LLC | Clinic/Center | 105 Metzler St, Johnstown, PA 15904-3124 | 2020-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407368699 | Shari Mcclaren | Counselor | 1360 Eisenhower Blvd, Ste 404, Johnstown, PA 15904 | 2017-10-29 |
| 1881126928 | Pain Medicine of York, LLC | Anesthesiology | 136 Jaycee Dr Ste 10, Johnstown, PA 15904 | 2017-03-29 |
| 1841660750 | Danielle Nicole Malzi | Occupational Therapist | 222 Luray Avenue, Johnstown, PA 15904 | 2015-10-05 |
| 1710393715 | Dlp Conemaugh Physician Practices LLC | Internal Medicine | 622 Dermuth St., Johnstown, PA 15904 | 2014-07-10 |
| 1043582406 | Bonifacio Tan Aguilera | Family Medicine | 307 Terlyn Drive, Johnstown, PA 15904 | 2012-02-01 |
| 1508159021 | Patricia S Sauka | Social Worker | 865 Eisenhower Boulevard, Johnstown, PA 15904 | 2011-05-17 |
| 1962703520 | Nathaniel Brett Beatty | Audiologist-Hearing Aid Fitter | 141 Town Center Drive, Johnstown, PA 15904 | 2010-11-12 |
| 1831324607 | Medcare Equipment Company, LLC | Durable Medical Equipment & Medical Supplies | 150 Atlantic Street, Johnstown, PA 15904 | 2009-05-22 |
| 1467667766 | Mary Alice K Burtnett | Occupational Therapist | 345 Vo Tech Drive, Johnstown, PA 15904 | 2007-05-11 |
| 1871717280 | Beverly Janik | Counselor | 214 College Park Plaza, Johnstown, PA 15904 | 2007-04-13 |
| Find all providers in zip 15904 | ||||
| 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 |
|---|---|---|---|---|
| 1902314719 | Renal Treatment Centers - Mid-atlantic Inc | Clinic/Center | 420 Napoleon Pl, Johnstown, PA 15901-2502 | 2018-01-15 |
| 1073575882 | Physicians Dialysis Acquisitions Inc | Clinic/Center | 344 Budfield St, Johnstown, PA 15904-3214 | 2006-04-05 |
| 1518506989 | Dialcare Dialysis LLC | Clinic/Center | 105 Metzler St, Johnstown, PA 15904-3124 | 2020-01-02 |
| 1831731249 | Home Dialysis Care LLC | Clinic/Center | 88 Osborne St, Johnstown, PA 15905-4146 | 2019-10-17 |
| 1366881591 | Total Renal Care Inc | Clinic/Center | 350 Budfield St, Ste 1, Johnstown, PA 15904-3214 | 2013-06-20 |
| 1912298605 | Choice Home Dialysis,llc | Clinic/Center | 350 Budfield St, Suite One, Johnstown, PA 15904-3214 | 2011-04-28 |
| 1811131782 | Prodigy Dialysis | Clinic/Center | 88 Osborne St, Johnstown, PA 15905-4146 | 2009-04-23 |
| 1023065554 | Prodigy Dialysis | Clinic/Center | 1111 Franklin St, Suite 220, Johnstown, PA 15905-4330 | 2006-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157123 | Fresenius Medical Care Southwest Pittsburgh, LLC | Clinic/Center | 3 Robinson Plz Ste 110, Pittsburgh, PA 15205-1018 | 2020-08-31 |
| 1295344307 | Isd Renal Inc | Clinic/Center | 1930 S Broad St Unit 7, Philadelphia, PA 19145-2328 | 2020-07-24 |
| 1225647332 | Isd Renal Inc | Clinic/Center | 230 N Broad St Bldg 12th, Philadelphia, PA 19102-1121 | 2020-07-24 |
| 1336758549 | Isd Renal Inc | Clinic/Center | 1300 W Lehigh Ave Ste 106, Philadelphia, PA 19132-2764 | 2020-07-24 |
| 1992323976 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 300 Cedar Ridge Dr Ste 302, Pittsburgh, PA 15205-1159 | 2020-07-07 |
| 1750906574 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 9333 State Route 61, Coal Township, PA 17866-4170 | 2020-06-09 |
| 1407479124 | Dialysis Clinic Inc | Clinic/Center | 1603 Carmody Ct Ste 103, Sewickley, PA 15143-8859 | 2020-05-28 |
| 1154944486 | Fresenius Medical Care Wyomissing, LLC | Clinic/Center | 656 Berkshire Blvd, Wyomissing, PA 19610 | 2020-05-21 |
| 1336774181 | Elkonson Dialysis LLC | Clinic/Center | 350 Tri County Ln, Rostraver Township, PA 15012-1990 | 2020-03-11 |
| 1417599168 | Renal Treatment Centers - Mid-atlantic Inc | Clinic/Center | 8000c Derry St, Harrisburg, PA 17111-5200 | 2019-10-15 |
| Find all providers with the same taxonomy | ||||
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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.