Lyndale Dialysis LLC

Primary specialty

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

Legal business name

LYNDALE DIALYSIS LLC

Doing business as

Deer Park Dialysis

Practice address

4401 Mack Rd
Sacramento, CA 95823-4545

Phone

(916) 738-3575

Fax

(916) 429-2368

NPI assigned

Dec 14, 2015

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

• Deer Park Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

DaVita Deer Park DialysisCCN 552814

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Oct 11, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

24

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

CLIA laboratory certificates

Member of 1

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Pai, MD

  • Nephrology Physician
  • Sacramento, CA
  • NPI 1023190808
  NPD (past)

Affiliated clinicians 6

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

• Eric Chang, M.D.

  • Nephrology Physician
  • Sacramento, CA
  • NPI 1477996031

  Dialysis facility

  Care Compare affiliation Name & address match
• Elena V Gelfand, M.D.

  • Nephrology Physician
  • Sacramento, CA
  • NPI 1154342343

  Dialysis facility

  Care Compare affiliation Name & address match
• Olivia Marie Orteza

  • Nephrology Physician
  • Sacramento, CA
  • NPI 1316395569

  Dialysis facility

  Care Compare affiliation Name & address match
• Ushir V Patel, M.D.

  • Nephrology Physician
  • Sacramento, CA
  • NPI 1285936757

  Dialysis facility

  Care Compare affiliation Name & address match
• Tariq Asudan Shaheed, D.O.

  • Nephrology Physician
  • Sacramento, CA
  • NPI 1467802546

  Dialysis facility

  Care Compare affiliation Name & address match
• Joseph A. De Leon, MD

  • Internal Medicine Physician
  • Wynnewood, PA
  • NPI 1821380551

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748476800000",
    "number": "1033584248",
    "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": "4401 MACK RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958234545",
            "telephone_number": "916-738-3575",
            "fax_number": "916-429-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNDALE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033584248",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deer Park Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Deer Park Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Isaac Lynch
• Janaye Lynch
• Rebecca Marrie Lynch, MD, MPH, MS
• Ryan Geffrey Lynch
• Star Louise Lynch
• Madison Lyndall
• Noah L Lyndall
• Jennifer Michelle Lynde, D.O.
• Lynn-Edwards Corporation
• Azra D. Lynn, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Sacramento, CA
• Providers in Sacramento, 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 May 29, 2025; 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.