Banfort Dialysis LLC

Primary specialty

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

Legal business name

BANFORT DIALYSIS LLC

Practice address

2606 W Pecan St
BLDG 3 Ste 300
Pflugerville, TX 78660-1917

Phone

(512) 990-7785

Fax

(512) 990-7811

NPI assigned

Dec 22, 2017

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

Sr Director Licensure&Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pflugerville Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

DaVita Pflugerville DialysisCCN 672889

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Oct 12, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

12

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.

• Renal Treatment Centers-Southeast, LP.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Donna, TX
  • NPI 1902353543

  Member Of

  NPD member

Locations

Affiliated clinicians 1

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

• Malavika Vinta, M.D.

  • Nephrology Physician
  • Austin, TX
  • NPI 1518903525

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1513900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1184130429",
    "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": "615-320-4224",
            "fax_number": "800-293-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 W PECAN ST",
            "address_2": "BLDG 3 STE 300",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786601917",
            "telephone_number": "512-990-7785",
            "fax_number": "512-990-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANFORT DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-22",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "SR DIRECTOR LICENSURE&CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "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": "3909798-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pflugerville Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Russell Edward Baker, DC
• Aishwarya Balaji
• Lakshmi Priya Balaraman, DDS
• Noemi Balderas
• Ronnette P. Ballard, PSY.D.
• William Barbrow III
• Fabeain Damonte Barkwell, LCSW
• Carrie Chandler Barlow, PA-C
• Emma Catherine Barnes, M.S., CCC-SLP
• Brianna Morrison Barnett

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pflugerville, TX
• Providers in Pflugerville, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.