Queens Boulevard Extended Care Facility Dialysis Center LLC
NPI 1619539996 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Woodside, NY
Enrolled with Medicare as Part a Provider - End-Stage Renal Disease Facility (esrd) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Queens Boulevard Extended Care Facility Dialysis Center LLC is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center organization in Woodside, NY (NPI 1619539996).
Provider details
- NPI number
- 1619539996
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- James Clemenza, Managing Member(718) 205-0287
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
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
Other names (DBA / former)
- Former legal business name
- Queens Boulevard Extended Care Dialysis Center LLC
- Former legal business name
- Queens Boulevard Extended Care Dialysis Center LLC
Additional practice locations (1)
- 6111 Queens BlvdWoodside, NY 11377-4965Phone: (718) 205-0287
Registry dates
- Enumerated
- 2019-07-08
- Last updated
- 2021-12-15
- Certified
- 2021-12-15
Frequently asked questions
- What is Queens Boulevard Extended Care Facility Dialysis Center LLC's NPI number?
- Queens Boulevard Extended Care Facility Dialysis Center LLC's National Provider Identifier (NPI) is 1619539996, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Queens Boulevard Extended Care Facility Dialysis Center LLC?
- Queens Boulevard Extended Care Facility Dialysis Center LLC is classified in the NPPES registry as End-Stage Renal Disease (ESRD) Treatment Clinic/Center (Ambulatory Health Care Facilities).
- Where is Queens Boulevard Extended Care Facility Dialysis Center LLC located?
- Queens Boulevard Extended Care Facility Dialysis Center LLC's practice location on file with NPPES is 6111 Queens Blvd, Woodside, NY 11377-4965.
- What is Queens Boulevard Extended Care Facility Dialysis Center LLC's phone number?
- The practice phone number listed in the NPPES registry for Queens Boulevard Extended Care Facility Dialysis Center LLC is (718) 205-0287.
- Does Queens Boulevard Extended Care Facility Dialysis Center LLC accept Medicare?
- Queens Boulevard Extended Care Facility 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 Queens Boulevard Extended Care Facility Dialysis Center LLC?
- The authorized official listed on Queens Boulevard Extended Care Facility Dialysis Center LLC's NPPES record is James Clemenza, Managing Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Queens Boulevard Extended Care Facility Dialysis Center LLC's NPI active?
- Yes — Queens Boulevard Extended Care Facility Dialysis Center LLC's NPI (1619539996) is active in the NPPES registry as of the last update on 2021-12-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.