NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as East Bay Peritoneal Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Leandro, CA
National Provider Identifier
1184683401
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
140000316 Issued in CA
Legal business name
TOTAL RENAL CARE INC
Doing business as
East Bay Peritoneal Dialysis Center
Practice address
13939 E 14TH St
Ste 110
San Leandro, CA 94578-2601
Phone
(510) 614-1380
Fax
(510) 614-0393
NPI assigned
Mar 23, 2006
Last updated
May 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 140000316 CA Primary

Addresses

Primary practice location

13939 E 14TH St
Ste 110
San Leandro, CA 94578-2601

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
1184683401MedicaidCA

Other names 1

  • East Bay Peritoneal Dialysis Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422000715 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: San Leandro, CA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita East Bay Peritoneal Dialysis CenterCCN 052675
Overall star rating
5.0 of 5
Ownership
Profit
Certified
Nov 4, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
4

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Hernando Kidney Center758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1184683401",
    "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": "13939 E 14TH ST",
            "address_2": "STE 110",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782601",
            "telephone_number": "510-614-1380",
            "fax_number": "510-614-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "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": "140000316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184683401",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Bay Peritoneal Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Bay Peritoneal Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.