Greater Los Angeles Dialysis Centers LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

930000461 Issued in CA

Legal business name

GREATER LOS ANGELES DIALYSIS CENTERS LLC

Doing business as

University Park Dialysis Center

Practice address

3986 S Figueroa St
Los Angeles, CA 90037-1222

Phone

(213) 749-8297

Fax

(213) 749-0472

NPI assigned

Apr 10, 2006

Last updated

Jun 7, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel T. Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• University Park Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Greater Los Angeles Dialysis Centers LLC

  dba Wilshire Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
  • NPI 1174586192

  5092740811

  Same PAC ID
• Greater Los Angeles Dialysis Centers LLC

  dba Hollywood Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
  • NPI 1700845286

  5092740811

  Same PAC ID

Listed as

DaVita University Park Dialysis CenterCCN 052713

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Jun 7, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

20

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Greater Los Angeles Dialysis Centers LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Greater Los Angeles Dialysis Centers LLC

  dba Wilshire Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
  • NPI 1174586192
  NPD tax ID
• Greater Los Angeles Dialysis Centers LLC

  dba Hollywood Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
  • NPI 1700845286
  NPD tax ID

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member
• Total Renal Care Inc

  dba Kenwood Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chicago, IL
  • NPI 1831896364

  Member Of

  NPD member

Locations

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• James T Roe, M.D.

  • Specialist
  • Los Angeles, CA
  • NPI 1881685956

  Dialysis facility

  Care Compare affiliation Name & address match
• Lin Wang

  • Nephrology Physician
  • Los Angeles, CA
  • NPI 1366974859

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1003879081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3986 S FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900371222",
            "telephone_number": "213-749-8297",
            "fax_number": "213-749-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER LOS ANGELES DIALYSIS CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "930000461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003879081",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Park Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Park Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lloyd Edward Greaser III, M.D.
• Great Eyes Optometry, Inc
• Great Health Medical Center Inc
• Greater Los Angeles Cardiology Medical Group (Cardiac Partners Medical Group Inc)
• Greater Los Angeles Cardiology Medical Group
• Greater Los Angeles Dialysis Centers LLC (Wilshire Dialysis Center)
• Greater Los Angeles Dialysis Centers LLC (Hollywood Dialysis Center)
• Greater Los Angeles Health Care System
• Greater Los Angeles Oncology Medical Corporation
• Michelle Larue Greathree

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.