Organization Active NPI

Fremont Dialysis LLC

Doing business as Bloomfield Hills Home Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bloomfield Hills, MI
National Provider Identifier
1467890616
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
FREMONT DIALYSIS LLC
Doing business as
Bloomfield Hills Home Dialysis
Practice address
42886 Woodward Ave
Bloomfield Hills, MI 48304-5033
Phone
(248) 334-7501
Fax
(248) 334-7384
NPI assigned
Jun 10, 2013
Last updated
Feb 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

42886 Woodward Ave
Bloomfield Hills, MI 48304-5033

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1467890616MedicaidMI

Other names 1

  • Bloomfield Hills Home Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130702000262 MI Part A Provider - End-Stage Renal Disease Facility (ESRD) 1658511233 Practice locations: Bloomfield Hills, MI

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Bloomfield Hills Home DialysisCCN 232697
Overall star rating
4.0 of 5
Ownership
Profit
Certified
Aug 7, 2014
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita

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
23D2061941Bloomfield Hills Home Dialysis42886 Woodward Avenue, Bloomfield Hills, MI 48304Certificate of waiverJul 8, 2027

National Provider Directory

National Provider Directory

Member of 1

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

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": "1370822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1467890616",
    "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": "42886 WOODWARD AVE",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045033",
            "telephone_number": "248-334-7501",
            "fax_number": "248-334-7384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-10",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "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": "1467890616",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloomfield Hills Home Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bloomfield Hills Home Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.