Sundance Home Dialysis LLC

Primary specialty

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

Legal business name

SUNDANCE HOME DIALYSIS LLC

Practice address

1809 Precinct Line Rd
Hurst, TX 76054-3132

Phone

(817) 840-5191

Fax

(817) 840-5192

NPI assigned

May 6, 2021

Last updated

Aug 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark R Nail

Title

Business Manager

Phone

(512) 826-3696

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Sundance Home DialysisCCN 742594

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Nov 15, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

2

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nishant B Jalandhara, MD

  • Nephrology Physician
  • Fort Worth, TX
  • NPI 1932116902
  NPD

Affiliated clinicians 2

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

• Nishant B Jalandhara, MD

  • Nephrology Physician
  • Fort Worth, TX
  • NPI 1932116902

  Dialysis facility

  Care Compare affiliation Name & address match
• Prejith P Rajendran, M.D.

  • Nephrology Physician
  • North Richland Hills, TX
  • NPI 1255758298

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1083298095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 BOOTH CALLOWAY RD STE 208",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761808362",
            "telephone_number": "817-512-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 PRECINCT LINE RD",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543132",
            "telephone_number": "817-840-5191",
            "fax_number": "817-840-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE HOME DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "NAIL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "512-826-3696",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Hurst, TX
• Providers in Hurst, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.