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LITTLE NECK DIALYSIS
NPI 1174018329
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Little Neck, NY

Active since June 28, 2018CLIA 33D2178861 · Waiver
25217 NORTHERN BLVD, LITTLE NECK, NY 11362(718) 292-3598(718) 292-3593 Get Directions Write a Review

NPPES record last updated: June 28, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Little Neck Dialysis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LITTLE NECK DIALYSIS (NPI 1174018329) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Little Neck, New York and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists James Hilger, Chief Accounting Officer, as its authorized official.

NPPES Registry Identity

NPI1174018329
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameKNICKERBOCKER DIALYSIS INC
Location Address25217 NORTHERN BLVDLittle Neck, NY 11362-1355
Mailing Address5200 Virginia Way, L And C DeptBrentwood, TN 37027-7569 · (615) 320-4414 · Fax (866) 865-2884
Phone(718) 292-3598
Fax(718) 292-3593
Organization SubpartNo
Authorized OfficialJames HilgerChief Accounting Officer · (615) 320-4414
Enumeration DateJune 28, 2018
✔ NPI 1174018329 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
25217 NORTHERN BLVD, Little Neck, NY 11362
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Other Names 1

Doing Business AsLittle Neck Dialysis

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2178861

Little Neck Dialysis · Little Neck, NY
Active · expires Mar 26, 2027
CLIA Number33D2178861
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateFebruary 11, 2020
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Gerard J. Tepedino
Laboratory Phone(718) 279-3589
Laboratory LocationLittle Neck Dialysis252-17 Northern Blvd, Little Neck, NY 11362
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Knickerbocker Dialysis Inc's NPI number?

The NPI number for Knickerbocker Dialysis Inc is 1174018329. It was assigned to this organization in the NPPES registry on June 28, 2018. The provider is doing business as Little Neck Dialysis.

Where is Knickerbocker Dialysis Inc located?

Knickerbocker Dialysis Inc is located at 25217 Northern Blvd, Little Neck, NY 11362. The listed phone number is (718) 292-3598.

What is Knickerbocker Dialysis Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Knickerbocker Dialysis Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2178861) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Knickerbocker Dialysis Inc was last updated on June 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.