KNICKERBOCKER DIALYSIS INC (NPI# 1508802968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508802968 |
| Entity Type | Organization |
| Organization Name | KNICKERBOCKER DIALYSIS INC |
| Other Organization Name | CATSKILL DIALYSIS CENTER |
| Practice Address |
139 Forestburgh Rd Monticello NY 12701-2348 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 8457963300 |
| Practice Fax Number | 8457963303 |
| Mailing Telephone | 6153416410 |
| Mailing Fax Number | 8886628259 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-07-30 |
| Authorized Official Name | JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03048780 | 05 |
| Other Name | Type Code |
|---|---|
| Catskill Dialysis Center | 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 |
139 FORESTBURGH RD |
| City | MONTICELLO |
| State | NY |
| Zip Code | 12701-2348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548726748 | Donna J Morgan | Dietitian, Registered | 139 Forestburgh Rd, Monticello, NY 12701-2348 | 2019-02-13 |
| 1407995384 | Juan Domingo Goyzueta | Internal Medicine | 139 Forestburgh Rd, Monticello, NY 12701-2348 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346854023 | Julia Lynn Waldorf | Student in an Organized Health Care Education/Training Program | 141 Benmosche Road, Monticello, NY 12701 | 2020-09-01 |
| 1205450483 | Deanna Marie Prue | Speech-Language Pathologist | 141 Benmosche Rd, Monticello, NY 12701 | 2020-06-03 |
| 1114552262 | Lauren Madsen | Physical Therapist | 139 Benmosche Rd, Monticello, NY 12701 | 2020-03-10 |
| 1427696061 | Elderberry Icf | Intermediate Care Facility, Mentally Retarded | 15 Poem Place, Monticello, NY 12701 | 2019-12-13 |
| 1407301922 | Nicole M Casamassima | Speech-Language Pathologist | 640 Old Route 17, 641 Old Route 17, Monticello, NY 12701 | 2016-08-25 |
| 1144680018 | Deborah Jackson | Counselor | 17 Hamilton Avenue, Monticello, NY 12701 | 2016-03-04 |
| 1215354592 | Abdelhalim Zaghloul Nada | Physical Therapist | 427 Boardway, Suite #3, Mountain Physical Therapy, Monticello, NY 12701 | 2014-03-25 |
| 1720402795 | Christine Pham | Podiatrist | 427 Broadway Ste 2, Monticello, NY 12701 | 2014-02-12 |
| 1396095139 | Raquel Bottaro | Specialist | 504 South Woods Rd, Monticello, NY 12701 | 2012-09-19 |
| 1558620310 | Maria L Burns | Registered Nurse | 20 Crystal St, Monticello, NY 12701 | 2012-05-14 |
| Find all providers in zip 12701 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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|---|---|---|---|---|
| 1770939241 | Bio-medical Applications of Kentucky, Inc. | Clinic/Center | 40 Walmart Plaza Dr, Monticello, KY 42633-7904 | 2016-05-13 |
| 1003915455 | Greater Lafayette Health Services | Clinic/Center | 1017 O Connor Blvd, Monticello, IN 47960-1600 | 2006-09-22 |
| 1285746180 | Jefferson County Dialysis Inc | Clinic/Center | 774 Jordan Dr, Monticello, AR 71655-5718 | 2006-08-31 |
| 1245287358 | Nra Monticello Georgia LLC | Clinic/Center | 1393 Funderburg Dr, Monticello, GA 31064-6818 | 2006-05-27 |
| 1497141576 | Dsi Macon, LLC | Clinic/Center | 1393 Funderburg Dr, Monticello, GA 31064-6818 | 2015-04-15 |
| 1518057918 | Liberty Dialysis - Lafayette LLC | Clinic/Center | 810 S 6th St, Monticello, IN 47960-8201 | 2006-10-13 |
| 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 |
| 1205461639 | Knickerbocker Dialysis Inc | Clinic/Center | 1277 Middle Country Rd, Middle Island, NY 11953 | 2020-03-05 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | MONTICELLO |
| Zip Code | 12701 |
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.