NPIMap

Organization Active NPI

Dialysis and Nephrology Consultants PC

  • Nephrology Physician
  • West Branch, MI
National Provider Identifier
1104891159
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
CM040033 Issued in MI
Legal business name
DIALYSIS AND NEPHROLOGY CONSULTANTS PC
Practice address
648 Progress Street
Ste 101
West Branch, MI 48661-8602
Phone
(989) 345-0204
Fax
(989) 345-3727
NPI assigned
Feb 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Authorized official

Name
Dr. Amanda Melissa Gomes, MDNPI 1649431321
Title
Owner/Provider
Phone
(314) 368-0824

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X CM040033 MI Primary

Addresses

Primary practice location

648 Progress Street
Ste 101
West Branch, MI 48661-8602

Mailing address

648 Progress Street
Ste 101
West Branch, MI 48661-8602
Phone (586) 446-8400

Other identifiers 2

IdentifierTypeStateIssuer
0090010OtherMIBLUE CROSS SHIELD MI
3037050MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050413000874 MI Part B Supplier - Clinic/Group Practice 3678510401 Receives reassigned benefits from 5 practitioners
Practice locations: Prudenville, MI; West Branch, MI; Saginaw, MI; Roscommon, MI; Pigeon, MI; Houghton Lake, MI; Bay City, MI; Bad Axe, MI

National Provider Directory

National Provider Directory

Locations

47718 Van Dyke Ave
Shelby Township, MI 48317

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1104891159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 PROGRESS STREET",
            "address_2": "STE 101",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486618602",
            "telephone_number": "586-446-8400",
            "fax_number": "586-446-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 PROGRESS STREET",
            "address_2": "STE 101",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486618602",
            "telephone_number": "989-345-0204",
            "fax_number": "989-345-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS AND NEPHROLOGY CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "GOMES",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "314-368-0824",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "CM040033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SHIELD MI",
            "identifier": "0090010",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3037050",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Branch, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.