Dva Renal Healthcare Inc

Primary specialty

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

Legal business name

DVA RENAL HEALTHCARE INC

Doing business as

Romulus Dialysis

Practice address

31470 Ecorse Rd
Romulus, MI 48174-1963

Phone

(734) 722-5455

Fax

(734) 722-5682

NPI assigned

Apr 3, 2006

Last updated

Apr 11, 2024By the provider in NPPES

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

• Romulus Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

DaVita Romulus DialysisCCN 232596

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Jun 6, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

12

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

Dva Renal Healthcare Inc173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 3

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

• Dva Renal Healthcare Inc

  dba Newaygo County Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fremont, MI
  • NPI 1629039144
  NPD tax ID
• Dva Renal Healthcare Inc

  dba Muskegon Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Muskegon, MI
  • NPI 1649231168
  NPD tax ID
• Dva Renal Healthcare Inc

  dba Ludington Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Ludington, MI
  • NPI 1760443279
  NPD tax ID

Member of 1

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

• Dva Healthcare Renal Care Inc

  dba Amelia Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Amelia Court House, VA
  • NPI 1861456113

  Member Of

  NPD member

Affiliated clinicians 2

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

• Naushad Pervez, MD

  • Nephrology Physician
  • Allen Park, MI
  • NPI 1962403170

  Dialysis facility

  Care Compare affiliation Name & address match
• Shazia Raza, MD

  • Nephrology Physician
  • Wayne, MI
  • NPI 1831176189

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1467414706",
    "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": "31470 ECORSE RD",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481741963",
            "telephone_number": "734-722-5455",
            "fax_number": "734-722-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4412100",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Romulus Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Romulus Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Romulus, MI
• Providers in Romulus, MI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.