NPIMap

Organization Active NPI

Physicians Dialysis Acquisitions Inc

Doing business as PDI Worcester

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Worcester, MA
National Provider Identifier
1346374436
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
PHYSICIANS DIALYSIS ACQUISITIONS INC
Doing business as
PDI Worcester
Practice address
19 Glennie St
Ste a
Worcester, MA 01605-3918
Phone
(508) 421-9539
Fax
(508) 421-6653
NPI assigned
Mar 14, 2007
Last updated
Feb 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

19 Glennie St
Ste a
Worcester, MA 01605-3918

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 320-4214

Other identifiers 1

IdentifierTypeStateIssuer
1322168MedicaidMA

Other names 1

  • PDI Worcester Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041014000093 MA Part A Provider - End-Stage Renal Disease Facility (ESRD) 2769399666 Practice locations: Worcester, MA

Other NPIs with the same Medicare PAC ID 9

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita PDI WorcesterCCN 222564
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Mar 10, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
29

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
22D1033198Pdi Worcester19 Glennie Street Suite a, Worcester, MA 01605Certificate of waiverNov 4, 2026

National Provider Directory

National Provider Directory
Tax ID family
Physicians Dialysis Acquisitions Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

19 Glennie St
#A
Worcester, MA 01605
Phone (508) 421-9539

Practitioners & affiliated clinicians

Affiliated clinicians 8

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": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1346374436",
    "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",
            "telephone_number": "615-320-4214",
            "fax_number": "866-944-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 GLENNIE ST",
            "address_2": "STE A",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053918",
            "telephone_number": "508-421-9539",
            "fax_number": "508-421-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS DIALYSIS ACQUISITIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "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": "1322168",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PDI Worcester",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PDI Worcester",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.