Fresenius Medical Care San Juan Capistrano, LLC

Primary specialty

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

Legal business name

FRESENIUS MEDICAL CARE SAN JUAN CAPISTRANO, LLC

Doing business as

Fresenius Medical Care San Juan Capistrano

Practice address

31001 Rancho Viejo Rd Ste 100
San Juan Capistrano, CA 92675-8704

Phone

(949) 240-0221

Fax

(949) 240-0543

NPI assigned

Nov 18, 2016

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

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

Authorized official

Name

Barry L. Blanton

Title

Vice President

Phone

(781) 699-9000

Specialties & licenses 1

Addresses

Other names 1

• FRESENIUS MEDICAL CARE SAN JUAN CAPISTRANO Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

FMC-San Juan CapistranoCCN 552892

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Mar 25, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Fresenius Medical Care

Dialysis stations

16

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 3

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

• Bio-Medical Applications of California, Inc.

  dba Fresenius Kidney Care North Fontana

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fontana, CA
  • NPI 1902387533

  Member Of

  NPD member
• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Member Of

  NPD member
• National Medical Care, Inc.

  dba Fresenius Medical Care Bristol

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bristol, TN
  • NPI 1477570117

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1467995746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31001 RANCHO VIEJO RD STE 100",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926758704",
            "telephone_number": "949-240-0221",
            "fax_number": "949-240-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31001 RANCHO VIEJO RD STE 100",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926758704",
            "telephone_number": "949-240-0221",
            "fax_number": "949-240-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE SAN JUAN CAPISTRANO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2016-11-18",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "BLANTON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "FRESENIUS MEDICAL CARE SAN JUAN CAPISTRANO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FRESENIUS MEDICAL CARE SAN JUAN CAPISTRANO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Link Fortmann, M.D.
• Kymry Hart Fowler, MS, CCC-SLP
• Howard B Fox, D.C.
• Cherie Francis
• Grace Fraser
• Ann Seaman Friedman, MFT
• Hope Frisch
• Daniel C Fry, DC
• Fullmotion Physical Therapy PC
• Sierra Gage, RN, CPNP-PC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in San Juan Capistrano, CA
• Providers in San Juan Capistrano, 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 19, 2023; 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.