KNICKERBOCKER DIALYSIS INC – NPI #1932135571
Clinic/Center

KNICKERBOCKER DIALYSIS INC is an AHC clinic located in BRONX, NY. NPPES has assigned the NPI number 1932135571 to KNICKERBOCKER DIALYSIS INC on June 24, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was last updated on Feb 18, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KNICKERBOCKER DIALYSIS INC below.

NPI Profile for
KNICKERBOCKER DIALYSIS INC

NPI Number
1932135571
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
KNICKERBOCKER DIALYSIS INC
Primary location
1940 WEBSTER AVE
STE 100
BRONX, NY 10457-4261
Phone: (718) 299-9212 Fax: (718) 583-7335
Mailing address
5200 VIRGINIA WAY
L&C DEPT
BRENTWOOD, TN 37027-7569
Phone: Fax:
Organization Subpart
No
Authorized Official
SAMUEL WEY
ASSISTANT SECRETARY
Phone: (615) 341-6641
Updated
Certification Date
Feb 18, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for KNICKERBOCKER DIALYSIS INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidNY03048597
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.