PRODIGY DIALYSIS (NPI# 1811131782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811131782 |
| Entity Type | Organization |
| Organization Name | PRODIGY DIALYSIS |
| Practice Address |
88 Osborne St Johnstown PA 15905-4146 |
| Practice Telephone | 8145390798 |
| Practice Fax Number | 8145364751 |
| Mailing Telephone | 8145390798 |
| Mailing Fax Number | 8145364751 |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2009-04-23 |
| Authorized Official Name | DR. GEORGE J FREM (CEO/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 |
| 1043393440 | Prodigy Dialysis | Clinic/Center | 105 Metzler St, Johnstown, PA 15904-3124 | 2006-10-23 |
| 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 |
| 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 |
88 OSBORNE ST |
| City | JOHNSTOWN |
| State | PA |
| Zip Code | 15905-4146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053315549 | George J Frem | Internal Medicine | 88 Osborne St, Johnstown, PA 15905-4146 | 2005-06-13 |
| 1831731249 | Home Dialysis Care LLC | Clinic/Center | 88 Osborne St, Johnstown, PA 15905-4146 | 2019-10-17 |
| 1487113627 | Samir Mallat | Internal Medicine | 88 Osborne St, Johnstown, PA 15905-4146 | 2019-03-18 |
| 1942773585 | Angela Marie Dill-simmons | Nurse Practitioner | 88 Osborne St, Johnstown, PA 15905-4146 | 2019-01-07 |
| 1821541848 | St Georges Lab LLC | Clinical Medical Laboratory | 88 Osborne St, Johnstown, PA 15905-4146 | 2016-07-26 |
| 1740543974 | Nina M Rucosky | Dietitian, Registered | 88 Osborne St, Johnstown, PA 15905-4146 | 2012-06-22 |
| 1962768754 | Renal Care Consultants, PC | Dietitian, Registered | 88 Osborne St, Johnstown, PA 15905-4146 | 2012-04-05 |
| 1588894547 | Megan Claire Montag | Dietitian, Registered | 88 Osborne St, Johnstown, PA 15905-4146 | 2009-07-23 |
| 1740433648 | Renal Care Consultants, PC | Physician Assistant | 88 Osborne St, Johnstown, PA 15905-4146 | 2008-10-23 |
| 1629032024 | Deborah K Menzie | Family Medicine | 88 Osborne St, Johnstown, PA 15905-4146 | 2006-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528552445 | Kristina Marie Sloan | Registered Nurse | Womens Center At Memorial Medical Center, 1111 Franklin St, Suite 210, Johnstown, PA 15905 | 2018-06-15 |
| 1376921403 | Joel Edward Messom | Obstetrics & Gynecology | 1111 Franklin St Ste 300, Johnstown, PA 15905 | 2015-05-08 |
| 1497091797 | Jessica Pacsai | Occupational Therapist | 807 Goucher Street, Johnstown, PA 15905 | 2012-12-14 |
| 1225396351 | Lusine Mesropyan | Surgery | 1086 Franklin Street Good Samaritan Building, Johnstown, PA 15905 | 2012-04-26 |
| 1467766931 | Kimberly Buchanan | Speech-Language Pathologist | 787 Goucher Street, Johnstown, PA 15905 | 2010-07-27 |
| 1205149846 | Lighthouse Medical, LLC | Clinic/Center | 507 Tire Hill Road, Suite 100, Johnstown, PA 15905 | 2010-07-26 |
| 1932357878 | Michael Cameron Sleet | Surgery | Dlp Conemaugh Memorial Hospital, 1086 Franklin Street, Johnstown, PA 15905 | 2008-09-04 |
| 1255528543 | Assisted Living Concepts Inc | Assisted Living Facility | 500 Cheney Oaks Drive, Johnstown, PA 15905 | 2007-10-01 |
| 1578766648 | Tamera Waggle | Nurse Anesthetist, Certified Registered | 1186 Franklin St., Johnstown, PA 15905 | 2007-06-07 |
| 1821206178 | Blue and Green Medical PC | Internal Medicine | 1743 Goucher Street, Johnstown, PA 15905 | 2007-05-18 |
| Find all providers in zip 15905 | ||||
| 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 |
| 1043393440 | Prodigy Dialysis | Clinic/Center | 105 Metzler St, Johnstown, PA 15904-3124 | 2006-10-23 |
| 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 |
| 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 |
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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.