Hunter Dialysis LLC

Primary specialty

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

License

550002148 Issued in CA

Legal business name

HUNTER DIALYSIS LLC

Doing business as

Moorpark Dialysis

Practice address

883 Patriot Dr
Ste C
Moorpark, CA 93021-3352

Phone

(805) 517-1442

Fax

(805) 517-1604

NPI assigned

Feb 5, 2014

Last updated

May 8, 2024By 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 T. Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Moorpark Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Hunter Dialysis LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Total Renal Care Inc

  dba Moorpark Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Moorpark, CA
  • NPI 1174883326
  NPD tax ID

Member of 1

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

• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1184048506",
    "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": "883 PATRIOT DR",
            "address_2": "STE C",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930213352",
            "telephone_number": "805-517-1442",
            "fax_number": "805-517-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTER DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-05",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "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": "CA",
            "license": "550002148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184048506",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moorpark Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moorpark Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Moorpark, CA
• Providers in Moorpark, 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 May 8, 2024; 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.