NPIMap

Organization Active NPI

Usrc Quincy, LLC

Doing business as U.S.Renal Care Quincy Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Quincy, MA
National Provider Identifier
1396118444
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
USRC QUINCY, LLC
Doing business as
U.S.Renal Care Quincy Dialysis
Practice address
500 Victory Rd
Quincy, MA 02171-3139
Phone
(617) 427-7800
Fax
(617) 427-7808
NPI assigned
Nov 10, 2015
Last updated
Jan 17, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
U.S. RENAL CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thomas L. Weinberg
Title
Chairman, Authorized Official
Phone
(214) 736-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

500 Victory Rd
Quincy, MA 02171-3139

Mailing address

PO Box 251549
Plano, TX 75025-1500
Phone (214) 736-2700

Other identifiers 4

IdentifierTypeStateIssuer
22D2032136OtherCLIA WAIVER
110115458AMedicaidMA
EK1NOtherMASTATE LICENSURE
7436OtherMABUSINESS LICENSE

Other names 1

  • U.S.Renal Care Quincy Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160426000979 MA Part A Provider - End-Stage Renal Disease Facility (ESRD) 2961701974 Practice locations: Quincy, MA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
USRC QuincyCCN 222576
Overall star rating
4.0 of 5
Ownership
Profit
Certified
Feb 2, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Chain
US Renal Care, Inc.
Dialysis stations
24

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
22D2032136Usrc Quincy,LLC500 Victory Road, Quincy, MA 02171Certificate of waiverNov 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
IHS of Massachusetts LLC2 organizations share this tax ID, including this one
Part of
US Renal Care Inc

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1396118444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251549",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251500",
            "telephone_number": "214-736-2700",
            "fax_number": "214-736-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VICTORY RD",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021713139",
            "telephone_number": "617-427-7800",
            "fax_number": "617-427-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC QUINCY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2015-11-10",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHAIRMAN, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVER",
            "identifier": "22D2032136",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110115458A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "EK1N",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "7436",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S.Renal Care Quincy Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.