NPIMap

Organization Active NPI

Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hayward, CA
National Provider Identifier
1013970516
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
140000341 Issued in CA
Legal business name
TOTAL RENAL CARE INC
Practice address
21615 Hesperian Blvd Ste F
Hayward, CA 94541-7026
Phone
(510) 780-9094
Fax
(510) 780-0635
NPI assigned
Apr 7, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Samuel T. Wey
Title
VP, Licensure & Certification
Phone
(615) 341-6641

Corporate family (same tax ID) 13

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

Affiliated clinicians 6

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Hayward Dialysis CenterCCN 052685
Overall star rating
4.0 of 5
Ownership
Profit
Certified
Oct 18, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
30

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0890721Hayward Dialysis Center21615 Hesperian Blvd, Hayward, CA 94541Certificate of waiverAug 23, 2026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040422000726 CA Part a Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Hayward, CA

National Provider Directory

National Provider Directory
Tax ID family
Davita Upstate Dialysis (758 organizations share this tax ID)

Locations

21615 Hesperian Blvd
Ste F
Hayward, CA 94541
Phone (510) 780-9094

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 140000341 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

21615 Hesperian Blvd Ste F
Hayward, CA 94541-7026

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1013970516MedicaidCA

Other names 1

NPPES NPI Registry
  • Hayward Dialysis Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 16, 2024.

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1013970516",
    "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": "21615 HESPERIAN BLVD STE F",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945417026",
            "telephone_number": "510-780-9094",
            "fax_number": "510-780-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "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": "140000341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013970516",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hayward Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hayward Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.