Isd Renal Inc

Primary specialty

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

License

KDT00741 Issued in RI

Legal business name

ISD RENAL INC

Doing business as

North Providence Renal Center

Practice address

1635 Mineral Spring Ave
North Providence, RI 02904-4025

Phone

(401) 354-5340

Fax

(401) 353-7020

NPI assigned

May 26, 2006

Last updated

Aug 28, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samuel Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Providence Renal Center Doing business as

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Isd Renal Inc

  dba Foreman Drive Home Training

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cookeville, TN
  • NPI 1003390469

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Greensboro Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Greensboro, GA
  • NPI 1073816914

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Fairmount Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1134640949

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Speedway Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Indianapolis, IN
  • NPI 1174006662

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Merchantville Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pennsauken, NJ
  • NPI 1194230441

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba National Road Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bridgeport, OH
  • NPI 1205396744

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Cedar Grove Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1235795204

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba South Dean Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Englewood, NJ
  • NPI 1245891670

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Girard Estates Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1295344307

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Upper Darby Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Upper Darby, PA
  • NPI 1316540388

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Mallory Park Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dayton, OH
  • NPI 1336682707

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Lehigh Avenue Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1336758549

  6507053790

  Same PAC ID

Listed as

DaVita North Providence Renal CenterCCN 412506

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Jun 7, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

18

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 3

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

• Dva Healthcare Renal Care Inc

  dba Amelia Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Amelia Court House, VA
  • NPI 1861456113

  Member Of

  NPD member
• Dva Renal Healthcare Inc

  dba Florissant Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saint Louis, MO
  • NPI 1740241454

  Member Of

  NPD member
• Isd Renal Inc

  dba Renal Care of Carthage

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Carthage, MS
  • NPI 1912952110

  Member Of

  NPD member

Affiliated clinicians 3

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

• Mary Anne Gaffney, MD

  • Nephrology Physician
  • Warwick, RI
  • NPI 1508166851

  Dialysis facility

  Care Compare affiliation Name & address match
• Susie Lee Hu, MD

  • Nephrology Physician
  • Riverside, RI
  • NPI 1083651301

  Dialysis facility

  Care Compare affiliation Name & address match
• Jie Tang, MD, MS, MPH

  • Nephrology Physician
  • Riverside, RI
  • NPI 1871583997

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1174579619",
    "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": "1635 MINERAL SPRING AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044025",
            "telephone_number": "401-354-5340",
            "fax_number": "401-353-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD RENAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": "RI",
            "license": "KDT00741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174579",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Providence Renal Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Providence Renal Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Inner Rhodes L3C
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• Jason Roger Izzi, D.M.D.
• Teresa Lorena Jeraldo, M.D.
• Joseph a. Izzi M.D., Inc.
• Glenda Kaija
• Jillian Karno

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in North Providence, RI
• Providers in North Providence, RI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.