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STATEN ISLAND DIALYSIS CENTER
NPI 1366876948
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Staten Island, NY

Active since August 30, 2013CLIA 33D2067682 · Waiver
3/5
Overall Rating
1139 HYLAN BLVD, STATEN ISLAND, NY 10305(718) 816-4913(718) 816-6340 Get Directions Write a Review

NPPES record last updated: February 29, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 6, 2020, Nov 27, 2019, Aug 28, 2018 (3 updates tracked since 2018).

About Staten Island Dialysis Center NPPES

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

STATEN ISLAND DIALYSIS CENTER (NPI 1366876948) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Staten Island, New York and active in the NPI registry since August 2013. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Samuel Wey, Vp, Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1366876948
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameKNICKERBOCKER DIALYSIS INC
Location Address1139 HYLAN BLVDStaten Island, NY 10305-2061
Mailing Address5200 Virginia Way, L & C DeptBrentwood, TN 37027-7569 · (615) 341-6410 · Fax (888) 662-8259
Phone(718) 816-4913
Fax(718) 816-6340
Organization SubpartNo
Authorized OfficialSamuel WeyVp, Licensure & Certification · (615) 341-6641
Enumeration DateAugust 30, 2013
Last NPPES UpdateFebruary 29, 20243 updates tracked since enumeration
NPPES CertifiedFebruary 29, 2024
✔ NPI 1366876948 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
License✔ Licensed in NY · 7000272R
1139 HYLAN BLVD, Staten Island, NY 10305
Open in Google Maps ↗

Other Names 1

Doing Business AsStaten Island Dialysis Center

Other Identifiers 1

Medicaid03911855NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

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 33D2067682

Staten Island Dialysis Center · Staten Island, NY
Active · expires Mar 26, 2027
CLIA Number33D2067682
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateOctober 21, 2013
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Meilin Zhang
Laboratory Phone(718) 816-4913
Laboratory LocationStaten Island Dialysis Center1139 Hylan Blvd, Staten Island, NY 10305
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for DaVita Staten Island Dialysis Center (CMS certification number 332711), from CMS Care Compare.

DaVita Staten Island Dialysis Center

Dialysis facility · Staten Island, NY
3/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainDaVita
CMS Certification Number332711
ESRD NetworkNetwork 2
Hemodialysis Stations18
Medicare-Certified SinceMay 9, 2014
Location1139 HYLAN BLVDStaten Island, NY 10305 · Richmond County
Phone(718) 816-4913
Services Offered
In-center hemodialysis Peritoneal dialysis Home hemodialysis training Evening shifts (after 5 PM)

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 1366876948. It was assigned to this organization in the NPPES registry on August 30, 2013. The provider is doing business as Staten Island Dialysis Center.

Where is Knickerbocker Dialysis Inc located?

Knickerbocker Dialysis Inc is located at 1139 Hylan Blvd, Staten Island, NY 10305. The listed phone number is (718) 816-4913.

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 33D2067682) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Knickerbocker Dialysis Inc a Medicare-certified dialysis facility?

Yes. DaVita Staten Island Dialysis Center is a Medicare-certified dialysis facility, certified since May 9, 2014.

What quality rating does Knickerbocker Dialysis Inc have?

CMS rates DaVita Staten Island Dialysis Center 3 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

What insurance does Knickerbocker Dialysis Inc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Oscar Health Insurance and Oscar Health Maintenance Organization of Florida and 5 other insurers list Knickerbocker Dialysis Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Knickerbocker Dialysis Inc was last updated on February 29, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.