Machesney Bay Dialysis, LLC

Primary specialty

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

Legal business name

MACHESNEY BAY DIALYSIS, LLC

Doing business as

Forest City Dialysis

Practice address

198 N Springfield Ave
Rockford, IL 61101-5086

Phone

(815) 962-8914

Fax

(815) 962-8952

NPI assigned

Feb 20, 2017

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 names 1

• Forest City Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Machesney Bay Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Machesney Park, IL
  • NPI 1770957599

  7911204078

  Same PAC ID

Listed as

DaVita Forest City DialysisCCN 142825

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 19, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

16

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

Forest City Dialysis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Machesney Bay Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Machesney Park, IL
  • NPI 1770957599
  NPD tax ID

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
  • Rockfrd, IL
  • NPI 1154997591

  Member Of

  NPD member

Locations

Affiliated clinicians 1

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

• Charlene D Murdakes, MD

  • Nephrology Physician
  • Rockford, IL
  • NPI 1992961593

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1033658349",
    "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": "198 N SPRINGFIELD AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611015086",
            "telephone_number": "815-962-8914",
            "fax_number": "815-962-8952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACHESNEY BAY DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest City Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Forest City Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen Lyons, L.C.S.W.
• M.H.R.C. Inc.
• Sarah Maas, APN, FNP-BC
• Sierra Maaske, APRN
• Nicole Oluwabunmi Macaulay, M.D
• Melissa Yvonne Macias, MD, PHD
• Amanda Macke, APN
• Sean P Mackenzie, M.D.
• Debra Mackey, RN
• Amanda Macquoid, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Rockford, IL
• Providers in Rockford, IL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.