Organization Active NPI

Dialysis Newco LLC

Doing business as U.S. Renal Care Scottsdale Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chicago, IL
National Provider Identifier
1053696674
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DIALYSIS NEWCO LLC
Doing business as
U.S. Renal Care Scottsdale Dialysis
Practice address
4651 W 79TH St
Unit #100
Chicago, IL 60652-1186
Phone
(773) 582-8911
Fax
(773) 582-8977
NPI assigned
Oct 14, 2011
Last updated
Jan 4, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
U.S. RENAL CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Authorized official

Name
Thomas L. Weinberg
Title
Authorized Official
Phone
(214) 736-2700

Specialties & licenses 1

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

Addresses

Primary practice location

4651 W 79TH St
Unit #100
Chicago, IL 60652-1186

Mailing address

PO Box 251549
Plano, TX 75025-1500
Phone (615) 234-1188

Other names 1

  • U.S. Renal Care Scottsdale Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111216000283 FL Part A Provider - End-Stage Renal Disease Facility (ESRD) 4789857905 Practice locations: Chicago, IL

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Usrc Scottsdale DialysisCCN 142518
Overall star rating
1.0 of 5
Ownership
Profit
Certified
Jun 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Chain
US Renal Care, Inc.
Dialysis stations
32

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
14D0676589US Renal Care Scottsdale Dialysis Dba4651 W 79TH St, Suite 100, Chicago, IL 60652Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Dialysis Newco LLC24 organizations share this tax ID, including this one
Part of
US Renal Care Inc

Other organizations with this tax ID 23

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

View all 23

Locations

4651 W 79th St
Ste 100
Chicago, IL 60652
Phone (773) 582-8911

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1318550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1053696674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251549",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251500",
            "telephone_number": "615-234-1188",
            "fax_number": "615-234-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 W 79TH ST",
            "address_2": "UNIT #100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606521186",
            "telephone_number": "773-582-8911",
            "fax_number": "773-582-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS NEWCO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2011-10-14",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "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": "U.S. Renal Care Scottsdale Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "U.S. Renal Care Scottsdale Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.