Dialysis Centers of Oregon, LLC

Primary specialty

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

License

394019 Issued in OR

Legal business name

DIALYSIS CENTERS OF OREGON, LLC

Practice address

1360 E Powell Blvd
Gresham, OR 97030-8004

Phone

(503) 465-1650

Fax

(503) 465-1449

NPI assigned

Jan 27, 2006

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• U.S. Renal Care Gresham Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Usrc Gresham DialysisCCN 382538

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Sep 26, 2000

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

15

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

CLIA laboratory certificates

Part of

US Renal Care Inc

Affiliated clinicians 4

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

• Chun Khai Chong, MD

  • Nephrology Physician
  • Portland, OR
  • NPI 1932367117

  Dialysis facility

  Care Compare affiliation Name & address match
• Janie Luong, DO

  • Nephrology Physician
  • Portland, OR
  • NPI 1528487527

  Dialysis facility

  Care Compare affiliation Name & address match
• Julie Raggio, MD

  • Nephrology Physician
  • Portland, OR
  • NPI 1467478289

  Dialysis facility

  Care Compare affiliation Name & address match
• Gurvinder S Suri, MD

  • Nephrology Physician
  • Portland, OR
  • NPI 1760507867

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385337600000",
    "number": "1093786105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WORLD TRADE CTR",
            "address_2": "STE 2500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908310002",
            "telephone_number": "562-495-8075",
            "fax_number": "562-495-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 E POWELL BLVD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308004",
            "telephone_number": "503-465-1650",
            "fax_number": "503-465-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CENTERS OF OREGON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2006-01-27",
        "last_updated": "2013-11-25",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OR",
            "license": "394019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "237718",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Gresham Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Densmore, LMT
• Sunita M Deshmukh, MD
• Linda Dewhitt, LPN
• Talia Rose Dewolfe
• Amber Dawn Deyo
• Marlene Diaz Aguilar
• Kylie Dieringer
• Robert Owen Dietz, DC
• Sarah Elizabeth Dilday, PWS/QMHA-I
• Kamilah Dillard

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Gresham, OR
• Providers in Gresham, OR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.