NPIMap

Organization Active NPI

Dva Renal Healthcare Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1558337352
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
930000937 Issued in CA
Legal business name
DVA RENAL HEALTHCARE INC
Practice address
8635 W 3Rd St
Ste 560W
Los Angeles, CA 90048-6110
Phone
(310) 855-1742
Fax
(310) 289-1032
NPI assigned
Feb 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Authorized official

Name
John D Winstel
Title
Chief Accounting Officer
Phone
(253) 733-4501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 930000937 CA Primary

Addresses

Primary practice location

8635 W 3Rd St
Ste 560W
Los Angeles, CA 90048-6110

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 238-3085

Other identifiers 1

IdentifierTypeStateIssuer
1558337352MedicaidCA

Other names 1

  • Tower Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030214000002 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 0840107611 Practice locations: Los Angeles, CA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Tower DialysisCCN 052643
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Jul 1, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
20

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
05D0962075Tower Dialysis8635 W 3Rd St Ste 560 W, Los Angeles, CA 90048Certificate of waiverJun 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Gambro Healthcare Anahe173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Practitioners & affiliated clinicians

Affiliated clinicians 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1558337352",
    "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",
            "telephone_number": "615-238-3085",
            "fax_number": "800-268-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST",
            "address_2": "STE 560W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486110",
            "telephone_number": "310-855-1742",
            "fax_number": "310-289-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "930000937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558337352",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tower Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tower Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.