Usrc Ewa Beach, LLC

Primary specialty

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

Legal business name

USRC EWA BEACH, LLC

Practice address

91-919 Fort Weaver Rd Ste 110
Ewa Beach, HI 96706-2257

Phone

(808) 664-8370

Fax

(808) 664-8374

NPI assigned

Mar 27, 2020

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

Chairman

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• U.S. Renal Care Ewa Beach Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Listed as

Usrc Ewa Beach DialysisCCN 122535

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Jul 24, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

25

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

Member of 1

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

• Dialysis Newco LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Viera, FL
  • NPI 1982970554

  Member Of

  NPD member

Locations

Affiliated clinicians 1

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

• Chintav Hiteshkumar Shah

  • Nephrology Physician
  • Honolulu, HI
  • NPI 1619474608

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585267200000",
    "number": "1164059168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 639924",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639924",
            "telephone_number": "808-664-8370",
            "fax_number": "808-664-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-919 FORT WEAVER RD STE 110",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967062257",
            "telephone_number": "808-664-8370",
            "fax_number": "808-664-8374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC EWA BEACH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHAIRMAN",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Ewa Beach Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ewa Beach, HI
• Providers in Ewa Beach, HI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.