Kidney Life, LLC
Kidney Life, LLC is a healthcare organization registered as End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Neptune, NJ, holding Type 2 (organization) NPI 1063446912 since 2006. The authorized official on file is Samuel Wey, Vp, Licensure & Certification.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1063446912 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Kidney Life, LLC |
| Other name | <Unavail> |
| Practice address | 2180 BRADLEY AVE, Neptune, NJ, 07753 |
| Phone | 7327752725 |
| Fax | 7327750500 |
| Enumeration date | 2006-07-10 |
| Last updated in NPPES | 2025-06-17 |
Authorized official
| Name | Samuel Wey |
|---|---|
| Title | Vp, Licensure & Certification |
| Phone | 6153416641 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QE0700X | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | Primary | 22845 | NJ |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0968528 | Medicaid | NJ | — |
Copy-ready billing details
Provider: Kidney Life, LLC NPI: 1063446912 Taxonomy: 261QE0700X (End-Stage Renal Disease (ESRD) Treatment Clinic/Center) Address: 2180 BRADLEY AVE, Neptune, NJ, 07753
Verify this record
Cross-check NPI 1063446912 against the authoritative CMS record: view Kidney Life, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Kidney Life, LLC?
Who is the authorized official for Kidney Life, LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-17.