Watkins Dialysis LLC

Primary specialty

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

Legal business name

WATKINS DIALYSIS LLC

Doing business as

San Bruno Dialysis

Practice address

841 San Bruno Ave W
San Bruno, CA 94066-3443

Phone

(650) 794-1138

Fax

(650) 794-1125

NPI assigned

Aug 7, 2018

Last updated

Apr 15, 2025By 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 names 1

• San Bruno Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

DaVita San Bruno DialysisCCN 552878

Overall star rating

5.0 of 5

Ownership

Profit

Certified

Nov 8, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

24

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 1

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

• Total Renal Care, Inc.

  dba Bountiful Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bountiful, UT
  • NPI 1184387516

  Member Of

  NPD member

Locations

Affiliated clinicians 5

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

• Warren Chang, MD

  • Nephrology Physician
  • Daly City, CA
  • NPI 1083674550

  Dialysis facility

  Care Compare affiliation Name & address match
• Christian Cosca Cruz, MD

  • Nephrology Physician
  • Daly City, CA
  • NPI 1023182227

  Dialysis facility

  Care Compare affiliation Name & address match
• Rashmi Jain, M.D.

  • Nephrology Physician
  • Burlingame, CA
  • NPI 1346444577

  Dialysis facility

  Care Compare affiliation Name & address match
• Albert C Kao, MD

  • Nephrology Physician
  • Daly City, CA
  • NPI 1225099286

  Dialysis facility

  Care Compare affiliation Name & address match
• Robert Ra Nien Tseng, MD

  • Nephrology Physician
  • Daly City, CA
  • NPI 1053371559

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1548749989",
    "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": "841 SAN BRUNO AVE W",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663443",
            "telephone_number": "650-794-1138",
            "fax_number": "650-794-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATKINS DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-08",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Bruno Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Morgan Walton
• Kelly Ying Yun Wang
• Pei Sheng Wang
• Ariel Ward
• Marlene Earlene Warsaw
• Avery Louis Watkins
• Jenna Watkins
• Consuelo N Watts
• John Wayland
• Billie Rene Webb

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in San Bruno, CA
• Providers in San Bruno, 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 Apr 15, 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.