West Elk Grove Dialysis LLC

Primary specialty

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

Legal business name

WEST ELK GROVE DIALYSIS LLC

Doing business as

West Elk Grove Dialysis

Practice address

2208 Kausen Dr
Ste 100
Elk Grove, CA 95758-7174

Phone

(916) 683-5992

Fax

(916) 683-6025

NPI assigned

Aug 28, 2007

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• West Elk Grove Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

DaVita West Elk Grove DialysisCCN 552604

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Aug 27, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

22

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

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

• Total Renal Care Inc

  dba Silverado Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Napa, CA
  • NPI 1295024206

  Member Of

  NPD member
• Total Renal Care Inc

  dba Cascade Dialysis

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

  Member Of

  NPD member

Locations

Practitioners 1

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

• Elena V Gelfand, M.D.

  • Nephrology Physician
  • Sacramento, CA
  • NPI 1154342343
  NPD (past)

Affiliated clinicians 3

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

• Elena V Gelfand, M.D.

  • Nephrology Physician
  • Sacramento, CA
  • NPI 1154342343

  Dialysis facility

  Care Compare affiliation Name & address match
• Ushir V Patel, M.D.

  • Nephrology Physician
  • Sacramento, CA
  • NPI 1285936757

  Dialysis facility

  Care Compare affiliation Name & address match
• Johan Winoto, M.D.

  • Nephrology Physician
  • Elk Grove, CA
  • NPI 1780635920

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1427242080",
    "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": "2208 KAUSEN DR",
            "address_2": "STE 100",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587174",
            "telephone_number": "916-683-5992",
            "fax_number": "916-683-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST ELK GROVE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "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": "1427242080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Elk Grove Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Elk Grove Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marc Weisman, DDS
• Haley Weld-Ramirez
• Well Ways Inc
• Aerial Wernecke
• Kenjie N Wessler
• Erica West
• Mackenzee West
• Marla Antoinette West, LVN
• Brittany Western
• Maryah Michelle Whalen-Moore

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.