NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Bay Shore Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Glendale, WI
National Provider Identifier
1235457508
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
TOTAL RENAL CARE INC
Doing business as
Bay Shore Dialysis
Practice address
5650 N Green Bay Ave
Suite 150
Glendale, WI 53209-4449
Phone
(414) 351-1290
Fax
(414) 351-1244
NPI assigned
May 12, 2010
Last updated
Aug 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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 NU Primary

Addresses

Primary practice location

5650 N Green Bay Ave
Suite 150
Glendale, WI 53209-4449

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1235457508MedicaidWI

Other names 1

  • Bay Shore Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100621000310 WI Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Glendale, WI

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Bay Shore DialysisCCN 522554
Overall star rating
3.0 of 5
Ownership
Profit
Certified
May 16, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
28

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
52D2011695Bay Shore Dialysis5650 North Green Bay Ave Suite 150, Glendale, WI 53209Certificate of waiverAug 19, 2026

National Provider Directory

National Provider Directory
Tax ID family
Springdale Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

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

View all 21

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1273622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785888000000",
    "number": "1235457508",
    "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": "5650 N GREEN BAY AVE",
            "address_2": "SUITE 150",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532094449",
            "telephone_number": "414-351-1290",
            "fax_number": "414-351-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-12",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235457508",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Shore Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bay Shore Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.