KNICKERBOCKER DIALYSIS INC (NPI# 1043839269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043839269 |
| Entity Type | Organization |
| Organization Name | KNICKERBOCKER DIALYSIS INC |
| Practice Address |
5518 Avenue N Brooklyn NY 11234-4006 |
| Mailing Address |
5200 Virginia Way L and C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 7182580609 |
| Practice Fax Number | 7182580269 |
| Mailing Telephone | 6153204414 |
| Mailing Fax Number | 8668652884 |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-04-09 |
| 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 |
|---|---|
| Kings Highway Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1487133633 | Knickerbocker Dialysis Inc | Clinic/Center | 54 New Lots Ave, Brooklyn, NY 11212-6934 | 2018-08-08 |
| Street Address |
5518 AVENUE N |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11234-4006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861000549 | Vanessa Clouden | Counselor | 651 East 59th St, Brooklyn, NY 11234 | 2020-07-17 |
| 1467098871 | Stephan Jean-claude | Licensed Practical Nurse | 853 Est 52nd St., Kings, NY 11234 | 2019-11-20 |
| 1356983167 | Barbara Baptiste | Family Medicine | 4710 Flatlands Ave, Brooklyn, NY 11234 | 2019-10-14 |
| 1376199141 | Sabrina Boutros | Physician Assistant | 1618 East 34th Street, Brooklyn, NY 11234 | 2019-08-16 |
| 1740846252 | Angelie Dawn Banaybanay Flores | Physical Therapist | 3214 Kings Highway, Brooklyn, New York, NY 11234 | 2019-05-10 |
| 1891273033 | Diana Haughton-bennett | Nurse Practitioner | 2067 E 60th St, Brooklyn, NY 11234 | 2018-07-31 |
| 1518450030 | Eduard Galper | Technician/Technologist | 2062 E 36th St, Brooklyn, NY 11234 | 2018-06-09 |
| 1538658448 | Vanessa Lee Hernandez | Nurse Practitioner | 3201 Kings Highway-emergency Room, Brooklyn, NY 11234 | 2018-05-07 |
| 1609377126 | Keisha Batson | Behavior Technician | 1669 E 48th St, Brooklyn, NY 11234 | 2018-02-21 |
| 1598280323 | Flex Rehab Physical Therapy PC | Physical Therapist | 1950 Coleman St, Brooklyn, NY 11234 | 2017-08-14 |
| Find all providers in zip 11234 | ||||
| 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 |
|---|---|---|---|---|
| 1659851442 | The Rogosin Institute Inc | Clinic/Center | 527 Court St, Brooklyn, NY 11231-4450 | 2018-08-21 |
| 1487133633 | Knickerbocker Dialysis Inc | Clinic/Center | 54 New Lots Ave, Brooklyn, NY 11212-6934 | 2018-08-08 |
| 1669959953 | Knickerbocker Dialysis Inc | Clinic/Center | 1641 E 16th St Fl 5, Brooklyn, NY 11229-1107 | 2018-07-19 |
| 1669961314 | Knickerbocker Dialysis Inc | Clinic/Center | 550 Kingston Ave, Brooklyn, NY 11203-1702 | 2018-05-08 |
| 1578063327 | Knickerbocker Dialysis Inc | Clinic/Center | 2064 Atlantic Ave, Brooklyn, NY 11233-3162 | 2018-02-19 |
| 1598264194 | Knickerbocker Dialysis Inc | Clinic/Center | 146 Meserole St, Brooklyn, NY 11206-2582 | 2018-02-08 |
| 1770027294 | Knickerbocker Dialysis Inc | Clinic/Center | 730 64th St, Brooklyn, NY 11220-4714 | 2016-12-19 |
| 1710399837 | Park Slope Dialysis Management, LLC | Clinic/Center | 672 Parkside Ave, Brooklyn, NY 11226-1506 | 2014-05-22 |
| 1982941290 | The Rogosin Institute Inc | Clinic/Center | 2372 Linden Blvd, Brooklyn, NY 11208-4821 | 2013-01-07 |
| 1730409301 | Midwood Chayim Aruchim Dialysis Associates, Inc | Clinic/Center | 4102 13th Ave, Brooklyn, NY 11219-1333 | 2010-06-07 |
| Find all providers in BROOKLYN | ||||
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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.