Organization Active NPI

Usrc Williamsville, Inc.

Doing business as US Renal Care Williamsville Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Williamsville, NY
National Provider Identifier
1093017634
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
USRC WILLIAMSVILLE, INC.
Doing business as
US Renal Care Williamsville Dialysis
Practice address
7964 Transit Rd
Suite 8-a
Williamsville, NY 14221-4117
Phone
(716) 634-1841
Fax
(716) 633-2605
NPI assigned
Dec 2, 2010
Organization subpart
Yes
Parent organization
US RENAL CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Authorized official

Name
Thomas L Weinberg
Title
Senior VP/General Counsel
Phone
(214) 736-2700

Specialties & licenses 1

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

Addresses

Primary practice location

7964 Transit Rd
Suite 8-a
Williamsville, NY 14221-4117

Mailing address

PO Box 19119
Jonesboro, AR 72403-6601
Phone (870) 931-5400

Other identifiers 1

IdentifierTypeStateIssuer
3454588MedicaidNY

Other names 1

  • US Renal Care Williamsville Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111118000196 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 9133393614 Practice locations: Williamsville, NY

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Usrc Williamsville DialysisCCN 332687
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Jan 20, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Chain
US Renal Care, Inc.
Dialysis stations
13

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
33D2030043Usrc Williamsville Inc7964 Transit Rd - Suite 8a, Williamsville, NY 14221Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Part of
US Renal Care Inc

Locations

7964 Transit Rd
#8A
Williamsville, NY 14221
Phone (716) 634-1841

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1093017634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19119",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724036601",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7964 TRANSIT RD",
            "address_2": "SUITE 8-A",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214117",
            "telephone_number": "716-634-1841",
            "fax_number": "716-633-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC WILLIAMSVILLE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE, INC.",
        "enumeration_date": "2010-12-02",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR VP/GENERAL COUNSEL",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3454588",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "US Renal Care Williamsville Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.