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STATEN ISLAND NEPHROLOGY PC
NPI 1982682001
Internal Medicine - Nephrology in Staten Island, NY

Active since January 09, 2006
1366 VICTORY BLVD, STATEN ISLAND, NY 10301(718) 727-3402(718) 727-3402 Get Directions Write a Review

NPPES record last updated: February 8, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Staten Island Nephrology Pc NPPES

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

STATEN ISLAND NEPHROLOGY PC (NPI 1982682001) is a healthcare organization registered as a nephrology in Staten Island, New York and active in the NPI registry since January 2006. The organization lists Eugene Petra, Owner, as its authorized official.

NPPES Registry Identity

NPI1982682001
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameSTATEN ISLAND NEPHROLOGY PC
Location Address1366 VICTORY BLVDStaten Island, NY 10301-3907
Mailing Address1366 Victory BlvdStaten Island, NY 10301-3907 · (718) 727-3402 · Fax (718) 727-3402
Phone(718) 727-3402
Fax(718) 727-3402
Organization SubpartNo
Authorized OfficialEugene PetraOwner · (718) 273-3400
Enumeration DateJanuary 9, 2006
Last NPPES UpdateFebruary 8, 2008
✔ NPI 1982682001 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.
1366 VICTORY BLVD, Staten Island, NY 10301
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Other Identifiers 2

Medicare PINW12651
Medicaid02544181NY

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Staten Island Nephrology Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Staten Island Nephrology PC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Susan Grossman, MDQ
Internal Medicine
NPI 1962513424
1366 VICTORY BLVD
Staten Island, NY 10301
(718) 273-3400
✔ PECOS✔ Accepts MedicareSame address
Jaudat Khan, MD
Nephrology
NPI 1457683179
1366 VICTORY BLVD
Staten Island, NY 10301
(718) 273-3400
✔ PECOS✔ Accepts MedicareSame address
Judith Mcloughlin, MD
Nephrology
NPI 1013995190
1366 VICTORY BLVD
Staten Island, NY 10301
(718) 273-3400
✔ PECOS✔ Accepts MedicareSame address
Meilin Zhang, MD
Nephrology
NPI 1083692727
1366 VICTORY BLVD
Staten Island, NY 10301
(718) 273-3400
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Staten Island Nephrology PC's NPI number?

The NPI number for Staten Island Nephrology PC is 1982682001. It was assigned to this organization in the NPPES registry on January 9, 2006.

Where is Staten Island Nephrology PC located?

Staten Island Nephrology PC is located at 1366 Victory Blvd, Staten Island, NY 10301. The listed phone number is (718) 727-3402.

What is Staten Island Nephrology PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Staten Island Nephrology PC enrolled in Medicare?

Yes. Staten Island Nephrology PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Staten Island Nephrology PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Staten Island Nephrology PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nephrology (3) and Internal Medicine (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Staten Island Nephrology PC was last updated on February 8, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.