Active NPI
Bonister Dialysis, LLC
Doing business as Sandy Shores Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Vero Beach, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- BONISTER DIALYSIS, LLC
- Doing business as
- Sandy Shores Dialysis
- Practice address
- 5947 20TH St
Vero Beach, FL 32966-4676 - Phone
- (772) 770-0331
- Fax
- (772) 770-0336
- NPI assigned
- Nov 8, 2018
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
5947 20TH St
Vero Beach, FL 32966-4676
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104083800 | Medicaid | FL |
Other names 1
- Sandy Shores Dialysis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190425000150 | FL | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 4183918139 | Practice locations: Vero Beach, FL |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Oslo Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Vero Beach, FL
- NPI 1821447962
4183918139
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- DaVita Sandy Shores Dialysis
- Overall star rating
- Ownership
- Profit
- Certified
- Jun 20, 2019
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 12
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
- Bonister Dialysis LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Oslo Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Vero Beach, FL
- NPI 1821447962
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Cascade Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Burlington, WA
- NPI 1932595584
Member Of
Locations
5947 20th St
Vero Beach, FL 32966
Phone (772) 770-0331
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nephrology Physician
- Fort Myers, FL
- NPI 1477882223
Affiliated clinicians 3
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": "1541635200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1777420800000",
"number": "1235607144",
"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": "5947 20TH ST",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329664676",
"telephone_number": "772-770-0331",
"fax_number": "772-770-0336"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BONISTER DIALYSIS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-11-08",
"last_updated": "2026-04-29",
"certification_date": "2026-04-29",
"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": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104083800",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Sandy Shores Dialysis",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Sandy Shores Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Vero Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.