Pattison Dialysis LLC

Primary specialty

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

Legal business name

PATTISON DIALYSIS LLC

Doing business as

Grant Line Dialysis

Practice address

2955 N Corral Hollow Rd
Ste 101
Tracy, CA 95376-8800

Phone

(209) 839-8302

Fax

(209) 839-8297

NPI assigned

Apr 3, 2018

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• Grant Line Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

DaVita Grant Line DialysisCCN 752508

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Apr 4, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

24

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

CLIA laboratory certificates

Member of 1

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

• Total Renal Care Inc

  dba Edgewater Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockfrd, IL
  • NPI 1154997591

  Member Of

  NPD member

Locations

Affiliated clinicians 4

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

• Smitha Reddy Anam, M.D

  • Nephrology Physician
  • Concord, CA
  • NPI 1093033276

  Dialysis facility

  Care Compare affiliation Name & address match
• Leena K Mehandru, M.D.

  • Nephrology Physician
  • Pleasanton, CA
  • NPI 1427096452

  Dialysis facility

  Care Compare affiliation Name & address match
• Mehul Raval, MD

  • Nephrology Physician
  • Stockton, CA
  • NPI 1710157474

  Dialysis facility

  Care Compare affiliation Name & address match
• Meenal Amish Shah, M.D.

  • Nephrology Physician
  • Tracy, CA
  • NPI 1346443991

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1093211609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 N CORRAL HOLLOW RD",
            "address_2": "STE 101",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953768800",
            "telephone_number": "209-839-8302",
            "fax_number": "209-839-8297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTISON DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-03",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093211609",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grant Line Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nisarg Patel, RPH
• Pranjalkumar H Patel, M.D.
• Ripal Rajeshbhai Patel
• Sunil H Patel, MD
• Andrea Patnaude
• Payang Enterprise LLC (Laguna ICF)
• Marche Lanisha Payne
• Jaime Cesario Payta
• Peak Pulmonary Services LLC
• Stacey Su-Chio Peak, PSY.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tracy, CA
• Providers in Tracy, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.