Isd Renal Inc

Primary specialty

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

Legal business name

ISD RENAL INC

Practice address

1700 NW 167TH PL Ste 230
Beaverton, OR 97006-4872

Phone

(503) 439-8829

Fax

(503) 439-9942

NPI assigned

May 3, 2011

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

• Cornell Road Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cookeville, TN
  • NPI 1003390469

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Greensboro, GA
  • NPI 1073816914

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1134640949

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Indianapolis, IN
  • NPI 1174006662

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • North Providence, RI
  • NPI 1174579619

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pennsauken, NJ
  • NPI 1194230441

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bridgeport, OH
  • NPI 1205396744

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1235795204

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Englewood, NJ
  • NPI 1245891670

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1295344307

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Upper Darby, PA
  • NPI 1316540388

  6507053790

  Same PAC ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dayton, OH
  • NPI 1336682707

  6507053790

  Same PAC ID

Listed as

DaVita Cornell Road DialysisCCN 382559

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Sep 21, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

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

Tax ID family

Renal Care of Marion88 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

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

• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Oregon City, OR
  • NPI 1023064474
  NPD tax ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Milwaukie, OR
  • NPI 1700832318
  NPD tax ID

Member of 2

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

• Dva Healthcare Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pearsall, TX
  • NPI 1194789859

  Member Of

  NPD member
• Dva Renal Healthcare Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pageland, SC
  • NPI 1548222615

  Member Of

  NPD member

Locations

Affiliated clinicians 3

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

• Pavan Chopra, MD

  • Nephrology Physician
  • Portland, OR
  • NPI 1851473730

  Dialysis facility

  Care Compare affiliation Name & address match
• Jennifer Kim Schneider, M.D.

  • Nephrology Physician
  • Hillsboro, OR
  • NPI 1316171242

  Dialysis facility

  Care Compare affiliation Name & address match
• Sarah A Zapata, MD

  • Nephrology Physician
  • Hillsboro, OR
  • NPI 1124279997

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1548552003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATTN: 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": "1700 NW 167TH PL STE 230",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064872",
            "telephone_number": "503-439-8829",
            "fax_number": "503-439-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD RENAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-03",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "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": "500644442",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornell Road Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cornell Road Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas Wade Irby, R.PH.
• Irina Moga DDS PC
• Evelyn Irish, COTA/L
• Lahela Joy Isaacson, LMFT
• Mariacristina Isaza-Chapman, MA. LPC
• Ajay Iselin
• Reid Yoshinobu Ishikawa, PHARM.D, RPH
• Kevin Naotaka Ishitani
• Robert Carl Isler III, PT
• Neveen Ismail, APRN

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Beaverton, OR
• Providers in Beaverton, OR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.