Tyler Dialysis LLC

Primary specialty

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

Legal business name

TYLER DIALYSIS LLC

Practice address

5261 Marlton Pike
Ste a
Pennsauken, NJ 08109-4758

Phone

(856) 438-7646

Fax

(856) 438-7647

NPI assigned

Sep 3, 2021

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 names 1

• South Jersey Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Tyler Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brooklawn, NJ
  • NPI 1154789659

  4284882036

  Same PAC ID
• Tyler Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mount Laurel, NJ
  • NPI 1215287941

  4284882036

  Same PAC ID
• Tyler Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mount Laurel, NJ
  • NPI 1760732408

  4284882036

  Same PAC ID
• Tyler Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Camden, NJ
  • NPI 1891044756

  4284882036

  Same PAC ID

Listed as

DaVita South Jersey TCUCCN 312716

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Jun 16, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

7

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

Lourdes Camden Dialysis5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Lourdes Dialysis at Innova, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mt. Laurel, NJ
  • NPI 1134373905
  NPD tax ID
• Tyler Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mount Laurel, NJ
  • NPI 1215287941
  NPD tax ID
• Tyler Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mount Laurel, NJ
  • NPI 1760732408
  NPD tax ID
• Tyler Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Camden, NJ
  • NPI 1891044756
  NPD tax ID

Member of 1

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

Affiliated clinicians 1

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

• Seema Sikand, MD

  • Nephrology Physician
  • Camden, NJ
  • NPI 1114023041

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1235807116",
    "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": "5261 MARLTON PIKE",
            "address_2": "STE A",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081094758",
            "telephone_number": "856-438-7646",
            "fax_number": "856-438-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-03",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Jersey Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Jersey Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Total Renal Care Inc
• Township of Pennsauken
• Christine Faith Tracy
• Aditi Trivedi, MD
• Talaura Truluck
• Samuel Udell, DPM
• Union Association of the Children'S Home of Burlington County, Inc.
• Unity Care Service DDD LLC
• Denisha Vanburen, LPC
• Vayana Organics LLC

• All providers in Pennsauken, NJ
• 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 Dec 4, 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.