NPIMap

Organization Active NPI

Star Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Medford, OR
National Provider Identifier
1306077680
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
STAR DIALYSIS LLC
Practice address
760 Golf View Dr
Unit 100
Medford, OR 97504-9685
Phone
(541) 776-4805
Fax
(541) 773-6016
NPI assigned
Aug 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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 Primary

Addresses

Primary practice location

760 Golf View Dr
Unit 100
Medford, OR 97504-9685

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
500617226MedicaidOR

Other names 1

  • Rogue Valley Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090924000510 OR Part A Provider - End-Stage Renal Disease Facility (ESRD) 3375699804 Practice locations: Medford, OR

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Rogue Valley DialysisCCN 382505
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Jan 22, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
39

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
38D0656900Rogue Valley Dialysis760 Golf View Dr Ste 100, Medford, OR 97504Certificate of waiverDec 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Grants Pass II Dialysis4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member of 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1249344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1306077680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: 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": "760 GOLF VIEW DR",
            "address_2": "UNIT 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049685",
            "telephone_number": "541-776-4805",
            "fax_number": "541-773-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-04",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-16",
        "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": "500617226",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rogue Valley Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rogue Valley Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.