NPIMap

Organization Active NPI

Dva Healthcare Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Delano, CA
National Provider Identifier
1194799544
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
240000778 Issued in CA
Legal business name
DVA HEALTHCARE RENAL CARE INC
Practice address
405 Dover Pkwy
Delano, CA 93215-3714
Phone
(661) 725-1370
Fax
(661) 725-1323
NPI assigned
Feb 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Authorized official

Name
Samuel T Wey
Title
Sr Dir Licensure & Certification
Phone
(615) 341-6641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 240000778 CA Primary

Addresses

Primary practice location

405 Dover Pkwy
Delano, CA 93215-3714

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 238-3085

Other identifiers 1

IdentifierTypeStateIssuer
1194799544MedicaidCA

Other names 1

  • Delano Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030430000005 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 7517875545 Practice locations: Delano, CA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Delano DialysisCCN 052674
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Oct 7, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
32

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0585153Delano Dialysis405 Dover Pkwy, Delano, CA 93215Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
CDS of Zephyrhills194 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

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

View all 17

Member of 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1194799544",
    "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": "615-238-3085",
            "fax_number": "800-268-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 DOVER PKWY",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932153714",
            "telephone_number": "661-725-1370",
            "fax_number": "661-725-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SR DIR 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": "240000778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194799544",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delano Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Delano Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Delano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.