Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Ellicott City Dialysis Center LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ellicott City, MD · enumerated 2007 · authorized official Jason Boucher, Cfo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1881716785

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Registry record

Entity type Organization (Type 2)

Legal business name Ellicott City Dialysis Center LLC

Practice address 3419 Plum Tree Dr, Suites 103-106, Ellicott City, MD, 21042

Phone (410) 750-8426

Fax (410) 750-8428

Enumeration date Apr 4, 2007

Last updated in NPPES Mar 22, 2019

Taxonomy & classification

261QE0700X End-Stage Renal Disease (ESRD) Treatment Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name Jason Boucher

Title Cfo

Phone (978) 922-3080

Other identifiers

Identifier	Type	State	Issuer
412495200	Medicaid	MD	-

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.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2019-03-22. Verify at npiregistry.cms.hhs.gov.

Where is Ellicott City Dialysis Center LLC located?

The practice location on file with NPPES is in Ellicott City, MD.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2019-03-22.