Gulch Dialysis LLC

Primary specialty

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

Legal business name

GULCH DIALYSIS LLC

Doing business as

Fashion Square Dialysis

Practice address

5641 Bay Rd
Saginaw, MI 48604-2509

Phone

(989) 249-1350

Fax

(989) 249-1170

NPI assigned

Jan 6, 2016

Organization subpart

No

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

Authorized official

Name

John Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fashion Square Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

DaVita Fashion Square DialysisCCN 232719

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 29, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

13

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 1

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Practitioners 1

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

• Aniruddha Venkatesh Palya, MD, MPH

  • Nephrology Physician
  • Flint, MI
  • NPI 1346485513
  NPD (past)

Affiliated clinicians 2

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

• Senthil Prakash Ramaiyah, M.D.

  • Nephrology Physician
  • Flint, MI
  • NPI 1699968628

  Dialysis facility

  Care Compare affiliation Name & address match
• Ahmad Waseef, MD

  • Nephrology Physician
  • Brooklyn, NY
  • NPI 1528227295

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1184080194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4514",
            "fax_number": "866-594-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5641 BAY RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042509",
            "telephone_number": "989-249-1350",
            "fax_number": "989-249-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULCH DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-06",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184080194",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fashion Square Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fashion Square Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Guided Grace
• Guided Grace
• Tilly Guild
• Andrew Guinn, OTRL
• Ramanarasimha Reddy Gujjula, PHARMACIST
• Caitlin Marie Guldenzoph, RDH
• Edith Gulick
• Evan Troy Gunden
• Manisha Gupta, M.D.
• Puneet Gupta, M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Saginaw, MI
• Providers in Saginaw, MI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.