NPIMap

Organization Active NPI

Renal Treatment Centers-Illinois Inc

Doing business as Flushing Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Flushing, MI
National Provider Identifier
1073574588
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
RENAL TREATMENT CENTERS-ILLINOIS INC
Doing business as
Flushing Dialysis Center
Practice address
3469 Pierson PL
Suite a
Flushing, MI 48433-2704
Phone
(810) 733-5004
Fax
(810) 733-5384
NPI assigned
Apr 1, 2006
Last updated
Jun 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 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 NU Primary

Addresses

Primary practice location

3469 Pierson PL
Suite a
Flushing, MI 48433-2704

Mailing address

5200 Virginia Way
Att: L&C Dept
Brentwood, TN 37027

Other identifiers 1

IdentifierTypeStateIssuer
4511190MedicaidMI

Other names 1

  • Flushing Dialysis Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041115000198 MI Part A Provider - End-Stage Renal Disease Facility (ESRD) 2365359965 Practice locations: Flushing, MI

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Flushing DialysisCCN 232601
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Dec 3, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
12

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
23D1001742Flushing Dialysis3469 Pierson Place, Flushing, MI 48433Certificate of waiverJul 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Renal Treatment Centers-Illinois Inc85 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

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": "1143849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1073574588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3469 PIERSON PL",
            "address_2": "SUITE A",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "484332704",
            "telephone_number": "810-733-5004",
            "fax_number": "810-733-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS-ILLINOIS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-01",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4511190",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flushing Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Flushing Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flushing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.