Ellenwood Dialysis Center, LLC
NPI 1235411406 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Ellenwood, GA
Enrolled with Medicare as Part a Provider - End-Stage Renal Disease Facility (esrd) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ellenwood Dialysis Center, LLC is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center organization in Ellenwood, GA (NPI 1235411406).
Provider details
- NPI number
- 1235411406
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mohamad Kassem, Owner/Medical Director(678) 392-6198
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2011-09-14
- Last updated
- 2011-09-14
Frequently asked questions
- What is Ellenwood Dialysis Center, LLC's NPI number?
- Ellenwood Dialysis Center, LLC's National Provider Identifier (NPI) is 1235411406, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ellenwood Dialysis Center, LLC?
- Ellenwood Dialysis Center, LLC is classified in the NPPES registry as End-Stage Renal Disease (ESRD) Treatment Clinic/Center (Ambulatory Health Care Facilities).
- Where is Ellenwood Dialysis Center, LLC located?
- Ellenwood Dialysis Center, LLC's practice location on file with NPPES is 209 Bennette Blvd, Ellenwood, GA 30294-2785.
- What is Ellenwood Dialysis Center, LLC's phone number?
- The practice phone number listed in the NPPES registry for Ellenwood Dialysis Center, LLC is (770) 996-6446.
- Does Ellenwood Dialysis Center, LLC accept Medicare?
- Ellenwood Dialysis Center, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Ellenwood Dialysis Center, LLC?
- The authorized official listed on Ellenwood Dialysis Center, LLC's NPPES record is Mohamad Kassem, Owner/Medical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ellenwood Dialysis Center, LLC's NPI active?
- Yes — Ellenwood Dialysis Center, LLC's NPI (1235411406) is active in the NPPES registry as of the last update on 2011-09-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.