Island Rehabilitative Services Corp
NPI 1669453502 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Staten Island, NY
Enrolled with Medicare as Part a Provider - End-Stage Renal Disease Facility (esrd) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Island Rehabilitative Services Corp is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center organization in Staten Island, NY (NPI 1669453502).
Provider details
- NPI number
- 1669453502
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Island Rehabilitative Services Corp
- Organization subpart
- Yes
- Authorized official
- Dominic Licciardi, Administrator(718) 987-5942
- License
- 7004204R (NY)
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
20 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
- 2005-11-08
- Last updated
- 2011-09-28
Frequently asked questions
- What is Island Rehabilitative Services Corp's NPI number?
- Island Rehabilitative Services Corp's National Provider Identifier (NPI) is 1669453502, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Island Rehabilitative Services Corp?
- Island Rehabilitative Services Corp is classified in the NPPES registry as End-Stage Renal Disease (ESRD) Treatment Clinic/Center (Ambulatory Health Care Facilities).
- Where is Island Rehabilitative Services Corp located?
- Island Rehabilitative Services Corp's practice location on file with NPPES is 25 Fanning St, Staten Island, NY 10314-5307.
- What is Island Rehabilitative Services Corp's phone number?
- The practice phone number listed in the NPPES registry for Island Rehabilitative Services Corp is (347) 671-8399.
- Does Island Rehabilitative Services Corp accept Medicare?
- Island Rehabilitative Services Corp 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 Island Rehabilitative Services Corp?
- The authorized official listed on Island Rehabilitative Services Corp's NPPES record is Dominic Licciardi, Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Island Rehabilitative Services Corp's NPI active?
- Yes — Island Rehabilitative Services Corp's NPI (1669453502) is active in the NPPES registry as of the last update on 2011-09-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.