NEW JERSEY KIDNEY CARE LLC - NPI 1194277392 - Internal Medicine in Jersey City, NJ

Q: What is the provider's specialty?

The provider's specialty is Internal Medicine with taxonomy code 207RN0300X and a focus in Nephrology.

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About New Jersey Kidney Care Llc NPPES

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

NEW JERSEY KIDNEY CARE LLC (NPI 1194277392) is a healthcare organization registered as a nephrology in Jersey City, New Jersey and active in the NPI registry since November 2016. The organization holds 2 active CLIA laboratory certificates, maintains 3 additional practice locations, and lists Ryan Valle, President, as its authorized official.

NPPES Registry Identity

NPI1194277392

Entity TypeOrganization

Primary Taxonomy207RN0300X

Legal Business NameNEW JERSEY KIDNEY CARE LLC

Location Address26 GREENVILLE AVEJersey City, NJ 07305-2608

Mailing Address26 Greenville AveJersey City, NJ 07305-2608 · (201) 333-8222 · Fax (201) 333-0095

Phone(201) 333-8222

Fax(201) 333-0095

Organization SubpartNo

Authorized OfficialRyan VallePresident · (781) 699-9362

Enumeration DateNovember 4, 2016

Last NPPES UpdateJuly 24, 20243 updates tracked since enumeration

NPPES CertifiedJuly 24, 2024

✔ NPI 1194277392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

26 GREENVILLE AVE, Jersey City, NJ 07305

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Secondary Practice Locations 3

Location 1862 BroadwayBayonne, NJ 07002-3054 · Phone (201) 333-8222 · Fax (201) 333-0095

Location 2510 31st St BsmtUnion City, NJ 07087-3907 · Phone (201) 866-3322 · Fax (201) 866-2289

Location 3377 Jersey Ave Ste 220Jersey City, NJ 07302-4396 · Phone (201) 333-8222 · Fax (201) 333-0095

Other Identifiers 1

Medicaid0595594NJ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

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 31D0107364

New Jersey Kidney Care, LLC · Union City, NJ

Active · expires Aug 31, 2026

CLIA Number31D0107364

Laboratory TypePhysician Office

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorLochana Manandhar

Laboratory Phone(201) 333-8222

Laboratory LocationNew Jersey Kidney Care, LLC510 31st Street, Union City, NJ 07087

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 31D0109297

New Jersey Kidney Care, LLC · Jersey City, NJ

Active · expires Jul 31, 2026

CLIA Number31D0109297

Laboratory TypePhysician Office

Certificate Effective DateAugust 1, 2024

Certificate Expiration DateJuly 31, 2026

Laboratory DirectorBassam Haddad

Laboratory Phone(201) 333-8222

Laboratory LocationNew Jersey Kidney Care, LLC26 Greenville Avenue, Jersey City, NJ 07305

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIRECT MEDS OF JERSEY CITY LLC

Pharmacy (Community/Retail Pharmacy)