WOODMERE DIALYSIS,LLC (NPI# 1699318675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699318675 |
| Entity Type | Organization |
| Organization Name | WOODMERE DIALYSIS,LLC |
| Other Organization Name | BAY BARK DALYSIS CENTER |
| Practice Address |
801 Co Op City Blvd Bronx NY 10475-1603 |
| Practice Telephone | 7182396444 |
| Mailing Telephone | 7182396444 |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2019-10-23 |
| Authorized Official Name | MILES DAVIS (DIRECTOR) |
| Authorized Official Telephone | 8009755201 |
| 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 | OPERATING CERTIFICATE | 2950210R | 01 |
| Other Name | Type Code |
|---|---|
| Bay Bark Dalysis Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750308748 | Woodmere Dialysis,llc | Clinic/Center | 121 Franklin Pl, Woodmere, NY 11598-1218 | 2006-07-16 |
| Street Address |
801 CO OP CITY BLVD |
| City | BRONX |
| State | NY |
| Zip Code | 10475-1603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467449355 | Hebrew Hospital Home, Inc. | Skilled Nursing Facility | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2005-10-05 |
| 1417585696 | Mst Khaleda Khatun | Internal Medicine | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2020-04-01 |
| 1518443415 | Ayesha Riaz | Internal Medicine | 801 Co Op City Blvd, Bronx, NY 10475 | 2018-07-13 |
| 1063914208 | John Bruce | Occupational Therapist | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2018-03-04 |
| 1942548250 | Carerite LLC | Technician/Technologist | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2013-01-21 |
| 1568720035 | Baypark Adc | Clinic/Center | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2012-05-02 |
| 1538352182 | Bay Park Center for Nursing and Rehabilitation, LLC | Skilled Nursing Facility | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2007-08-27 |
| 1871628800 | Laurie R Mallis | Internal Medicine | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2007-02-22 |
| 1942297783 | Hebrew Hospital Home, Inc. - Adult Day Care Bronx | Clinic/Center | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2005-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973048 | Sharon Antoinette Hall | Registered Nurse | 2552 Pelham Bay Park West, Apt 1 D, 2551 Pelham Bay Park West, Bronx, NY 10475 | 2019-07-11 |
| 1265912042 | Bartow Pharmacy Inc. | Pharmacy | 500-5 Baychester Ave. Store #5, Bronx, NY 10475 | 2018-08-21 |
| 1518465996 | Jacqueline Caraballo | Nurse Practitioner | 100 De Kruif Place Apt 27h, Bronx, NY 10475 | 2018-01-31 |
| 1093227142 | Rachel Obeng Mireku | Licensed Practical Nurse | 140 Dekruif Place, Apt # 26k, Bronx, NY 10475 | 2017-10-30 |
| 1023534518 | Nelson Merritt Hall | Chiropractor | 2100 Bartow Ave, Ste #227, Bronx, NY 10475 | 2017-08-17 |
| 1245769363 | Sharon Holland Johnson | Licensed Practical Nurse | 140 Dekruif Pl, Bronx, NY 10475 | 2017-06-12 |
| 1740719152 | Nadia S Etienne | Licensed Practical Nurse | 120 De Kruif Place, Apt 18h, Bronx, NY 10475 | 2017-06-08 |
| 1407385891 | Ashley N Freeze | Case Manager/Care Coordinator | 140 Darrow Place Suite 24e, Bronx, NY 10475 | 2017-06-08 |
| 1912454091 | Usth.inc | Early Intervention Provider Agency | 120 Coop City Blvd, 21-f, Bronx, NY 10475 | 2016-09-06 |
| 1447626130 | Zelda Boomer | Registered Nurse | 920 Coop City Blvd Bx. Ny 10475, Bronx, NY 10475 | 2015-08-17 |
| Find all providers in zip 10475 | ||||
| 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 |
| 1013410133 | Knickerbocker Dialysis Inc | Clinic/Center | 2190 Jerome Ave, Bronx, NY 10453-1815 | 2018-03-15 |
| 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 |
| Find all providers in BRONX | ||||
Please comment or provide details below to improve the information on WOODMERE DIALYSIS,LLC.
| 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.