KNICKERBOCKER DIALYSIS INC (NPI# 1205461639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205461639 |
| Entity Type | Organization |
| Organization Name | KNICKERBOCKER DIALYSIS INC |
| Practice Address |
1277 Middle Country Rd Middle Island NY 11953 |
| Mailing Address |
5200 Virginia Way L and C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 6312050132 |
| Practice Fax Number | 6312050171 |
| Mailing Telephone | 6153204414 |
| Mailing Fax Number | 8668652884 |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2020-03-05 |
| Authorized Official Name | JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 6153204414 |
| Is Organization Subpart | Y |
| Parent Organization Name | DAVITA INC |
| 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 |
|---|---|
| Middle Island Home Training | 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 |
| 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 |
| 1487133633 | Knickerbocker Dialysis Inc | Clinic/Center | 54 New Lots Ave, Brooklyn, NY 11212-6934 | 2018-08-08 |
| Street Address |
1277 MIDDLE COUNTRY RD |
| City | MIDDLE ISLAND |
| State | NY |
| Zip Code | 11953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598252553 | Karen Simpson | Dietitian, Registered | 23 Summersweet Drive, Middle Island, NY 11953 | 2018-04-16 |
| 1699285502 | Amanda Rebekah Maye | Licensed Practical Nurse | 24 Wilson Avenue, Middle Island, NY 11953 | 2017-10-05 |
| 1982042065 | Shanti Kumari Chand | Licensed Practical Nurse | 49 Crest St, Oak Hollow Nursing Center, Middle Island, NY 11953 | 2013-06-11 |
| 1154664886 | Achieve Beyond Oediatric Therapy and Early Intervention Services | Early Intervention Provider Agency | 1103 Stonegate Way, Middle Island, NY 11953 | 2013-04-01 |
| 1831434018 | Amanda M Titus | Licensed Practical Nurse | 6 Redbud Ct, Middle Island, NY 11953 | 2012-11-29 |
| 1740561810 | Daniel Joseph Mckiernan | Registered Nurse | 217 Lake Point Cir, Middle Island, NY 11953 | 2011-09-02 |
| 1760787212 | Marissa Rodriguez | Speech-Language Pathologist | 41 Yaphank Middle Island Rd, Middle Island, NY 11953 | 2011-01-13 |
| 1376861542 | Sara Buckley | Licensed Practical Nurse | 341 Lake Pointe Dr, Middle Island, NY 11953 | 2010-05-12 |
| 1669645818 | Kimberley Jean Levy | Physician Assistant | 281 Middle Country Road, Middle Islana, NY 11953 | 2008-04-09 |
| 1932387230 | Saul Philip Kirschenbaum | Psychologist | Longwood Road, Just Kids Diagnostic & Treatment Center, Middle Island, NY 11953 | 2008-02-08 |
| Find all providers in zip 11953 | ||||
| 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 |
|---|---|---|---|---|
| 1194323071 | True North Dialysis Center LLC | Clinic/Center | 668 Middle Country Rd, Selden, NY 11784-2521 | 2020-10-13 |
| 1952908386 | Ulster Dialysis, LLC | Clinic/Center | 900 Miron Ln, Kingston, NY 12401-1567 | 2020-10-08 |
| 1376152868 | True North Dialysis Center LLC | Clinic/Center | 3005 Long Beach Rd, Oceanside, NY 11572 | 2020-07-30 |
| 1043839269 | Knickerbocker Dialysis Inc | Clinic/Center | 5518 Avenue N, Brooklyn, NY 11234-4006 | 2020-04-09 |
| 1942839378 | Knickerbocker Dialysis Inc | Clinic/Center | 479 E Main St, Patchogue, NY 11772-3147 | 2020-04-07 |
| 1225667819 | New York Dialysis Services, Inc | Clinic/Center | 1 East Jericho Turnpike, Mineola, NY 11501 | 2020-04-06 |
| 1326678111 | New York Dialysis Services, Inc | Clinic/Center | 794 St Anns Ave, Bronx, NY 10456 | 2020-01-21 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLE ISLAND |
| Zip Code | 11953 |
Please comment or provide details below to improve the information on KNICKERBOCKER DIALYSIS INC.
| 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.