NPIMap

Organization Active NPI

Physicians Dialysis Acquisitions Inc

Doing business as PDI Rocky Hill

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rocky Hill, CT
National Provider Identifier
1053387738
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
270 Issued in CT
Legal business name
PHYSICIANS DIALYSIS ACQUISITIONS INC
Doing business as
PDI Rocky Hill
Practice address
30 Waterchase Dr
Rocky Hill, CT 06067-2110
Phone
(860) 563-6000
Fax
(860) 257-3895
NPI assigned
Feb 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 270 CT Primary

Addresses

Primary practice location

30 Waterchase Dr
Rocky Hill, CT 06067-2110

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
004219178MedicaidCT

Other names 1

  • PDI Rocky Hill Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041129000061 CT Part A Provider - End-Stage Renal Disease Facility (ESRD) 2769399666 Practice locations: Rocky Hill, CT

Other NPIs with the same Medicare PAC ID 9

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita PDI Rocky HillCCN 072518
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Dec 15, 1999
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
24

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
07D0962839Pdi-Rocky Hill30 Waterchase Drive, Rocky Hill, CT 06067Certificate of waiverJun 20, 2028

National Provider Directory

National Provider Directory
Tax ID family
Physicians Dialysis Acquisitions Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

30 Waterchase Dr
Ste 1
Rocky Hill, CT 06067

Practitioners & affiliated clinicians

Affiliated clinicians 5

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

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1053387738",
    "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": "30 WATERCHASE DR",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672110",
            "telephone_number": "860-563-6000",
            "fax_number": "860-257-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS DIALYSIS ACQUISITIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "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": "CT",
            "license": "270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004219178",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PDI Rocky Hill",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PDI Rocky Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocky Hill, CT

Sources for this page

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