Bridges Dialysis LLC

Primary specialty

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

Legal business name

BRIDGES DIALYSIS LLC

Doing business as

Appleseed Dialysis

Practice address

1833 Magnavox Way
Fort Wayne, IN 46804-1539

Phone

(260) 432-1036

Fax

(260) 432-2085

NPI assigned

Feb 18, 2011

Last updated

Oct 4, 2022By 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

John D Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Appleseed Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

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

• Bridges Dialysis LLC

  dba Fort Wayne South Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Wayne, IN
  • NPI 1003119876

  5890976450

  Same PAC ID
• Bridges Dialysis LLC

  dba Fort Wayne West Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Wayne, IN
  • NPI 1366745630

  5890976450

  Same PAC ID
• Bridges Dialysis LLC

  dba Summit City Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Wayne, IN
  • NPI 1558635276

  5890976450

  Same PAC ID

Listed as

DaVita Appleseed DialysisCCN 152649

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Nov 28, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

4

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

Bridges Dialysis LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Bridges Dialysis LLC

  dba Fort Wayne South Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Wayne, IN
  • NPI 1003119876
  NPD tax ID
• Bridges Dialysis LLC

  dba Fort Wayne West Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Wayne, IN
  • NPI 1366745630
  NPD tax ID
• Bridges Dialysis LLC

  dba Summit City Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Wayne, IN
  • NPI 1558635276
  NPD tax ID

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Nephrology Associates of Northern Indiana, Inc

  • Nephrology Physician
  • Fort Wayne, IN
  • NPI 1578505814

  Member Of

  NPD member
• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member

Affiliated clinicians 5

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

• Garima Gupta, MD

  • Nephrology Physician
  • Fort Wayne, IN
  • NPI 1073729125

  Dialysis facility

  Care Compare affiliation Name & address match
• Irfan Munir

  • Nephrology Physician
  • Fort Wayne, IN
  • NPI 1073515086

  Dialysis facility

  Care Compare affiliation Name & address match
• Andrew W O'Shaughnessy, MD

  • Nephrology Physician
  • Fort Wayne, IN
  • NPI 1568416865

  Dialysis facility

  Care Compare affiliation Name & address match
• Maria Regina Valcarcel, MD

  • Nephrology Physician
  • Fort Wayne, IN
  • NPI 1801054358

  Dialysis facility

  Care Compare affiliation Name & address match
• Kanakapura Venkatakrishna, MD

  • Nephrology Physician
  • Fort Wayne, IN
  • NPI 1144222142

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1093012544",
    "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": "370277569",
            "telephone_number": "615-320-4514",
            "fax_number": "866-594-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 MAGNAVOX WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041539",
            "telephone_number": "260-432-1036",
            "fax_number": "260-432-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGES DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-18",
        "last_updated": "2022-10-04",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201048220 A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Appleseed Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Appleseed Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Joseph-Dewayne Brewer
• Emma Brewer
• Logan Bricault
• Chelsea Bridge
• Bridges Dialysis LLC (Fort Wayne South Dialysis)
• Bridges Dialysis LLC (Fort Wayne West Dialysis)
• Bridges Dialysis LLC (Summit City Dialysis)
• Bridges Emotional Wellness Clinic, Inc
• Christian H Bridgwater, DO
• Kristine Briggs-Connelly, MSPT

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.