Isd Renal Inc

Primary specialty

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

Legal business name

ISD RENAL INC

Practice address

1930 S Broad St Unit 7
Philadelphia, PA 19145-2328

Phone

(215) 463-3120

Fax

(215) 463-3107

NPI assigned

Jul 24, 2020

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

• Girard Estates Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

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

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1134640949

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1235795204

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Upper Darby, PA
  • NPI 1316540388

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1336758549

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1417566621

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lansdale, PA
  • NPI 1730697939

  6507053790

  Same PAC ID
• Isd Renal, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1306322516

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cookeville, TN
  • NPI 1003390469

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Greensboro, GA
  • NPI 1073816914

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Indianapolis, IN
  • NPI 1174006662

  6507053790

  Same PAC ID
• Isd Renal Inc

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

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pennsauken, NJ
  • NPI 1194230441

  6507053790

  Same PAC ID

Listed as

DaVita Girard Estates DialysisCCN 392823

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Jul 10, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

21

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

Renal Care of Marion88 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 9

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

• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1134640949
  NPD tax ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1235795204
  NPD tax ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Upper Darby, PA
  • NPI 1316540388
  NPD tax ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1336195742
  NPD tax ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1336758549
  NPD tax ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1376580464
  NPD tax ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1417566621
  NPD tax ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lansdale, PA
  • NPI 1730697939
  NPD tax ID
• Isd Renal, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1306322516
  NPD tax ID

Member of 1

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

• Dva Healthcare Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pearsall, TX
  • NPI 1194789859

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian P Conboy, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
  • NPI 1922014554
  NPD (past)
• Clenton L Coleman, MD

  • Nephrology Physician
  • Teaneck, NJ
  • NPI 1730379025
  NPD (past)

Affiliated clinicians 2

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

• Larry E Krevolin, DO

  • Nephrology Physician
  • Philadelphia, PA
  • NPI 1265532923

  Dialysis facility

  Care Compare affiliation Name & address match
• Surekha Neeli, MD

  • Nephrology Physician
  • Phoenixville, PA
  • NPI 1649424474

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1295344307",
    "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": "1930 S BROAD ST UNIT 7",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452328",
            "telephone_number": "215-463-3120",
            "fax_number": "215-463-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD RENAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-24",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "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": "1020290100012",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Girard Estates Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Girard Estates Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gabriel Isaza Gonzalez
• Emily Lynn Isch, MD
• Isd Renal Inc
• Isd Renal Inc
• Isd Renal Inc
• Isd Renal Inc
• Isd Renal Inc
• Isd Renal Inc
• Isd Renal Inc
• Isd Renal, Inc

• All providers in Philadelphia, PA
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.