Isd Renal Inc

Primary specialty

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

Legal business name

ISD RENAL INC

Doing business as

Merchantville Dialysis

Practice address

5000 N Crescent Blvd
Ste 1a
Pennsauken, NJ 08109-2151

Phone

(856) 910-8798

Fax

(856) 910-8794

NPI assigned

Dec 8, 2017

Last updated

Jan 10, 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 Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Merchantville Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

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 South Dean Dialysis

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

  6507053790

  Same PAC ID
• 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 North Providence Renal Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • North Providence, RI
  • NPI 1174579619

  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 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 Merchantville DialysisCCN 312685

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Sep 4, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

19

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Osceola Dialysis88 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

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

• Isd Renal Inc

  dba South Dean Dialysis

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

Member of 1

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

• Dva Healthcare Renal Care Inc

  dba Three Chopt Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Richmond, VA
  • NPI 1154385375

  Member Of

  NPD member

Locations

Affiliated clinicians 2

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

• Jason Andrew Kline, M.D.

  • Nephrology Physician
  • Camden, NJ
  • NPI 1912115296

  Dialysis facility

  Care Compare affiliation Name & address match
• Valerie Ofune Nwanji, MD

  • Nephrology Physician
  • Cherry Hill, NJ
  • NPI 1912499195

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1194230441",
    "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",
            "telephone_number": "615-341-6410",
            "fax_number": "888-662-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 N CRESCENT BLVD",
            "address_2": "STE 1A",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081092151",
            "telephone_number": "856-910-8798",
            "fax_number": "856-910-8794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD RENAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-08",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06511117",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Merchantville Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Mae Hopkins
• Khai X Huynh
• Peter-Toan Ke Huynh
• Inner Peace Counseling and Therapeutic Services
• Lucian J Introcaso, MD
• Ivy Stone Community Living LLC
• Katia Kristina Jackson
• James a. Spinelli D.D.S. P.a.
• Takira Sharae Jefferson
• Sung Joo Jeong, D.D.S.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsauken, NJ
• Providers in Pennsauken, NJ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.