Wyandot Dialysis Clinic LLC

Primary specialty

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

Legal business name

WYANDOT DIALYSIS CLINIC LLC

Practice address

1207 E Wyandot Ave
Upper Sandusky, OH 43351-9647

Phone

(513) 673-5245

NPI assigned

Jun 4, 2020

Last updated

Jun 4, 2020By 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

Ms. Sandra D Fritzsch

Title

Administrator

Phone

(513) 673-5245

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Listed as

Wyandot Dialysis Clinic LLCCCN 362896

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Dec 7, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

7

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benahili U Iboaya, DO

  • Nephrology Physician
  • Findlay, OH
  • NPI 1699755876
  NPD
• Hannah Rose Van Heck, CNP

  • Family Nurse Practitioner
  • Findlay, OH
  • NPI 1386486025
  NPD (past)

Affiliated clinicians 1

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

• Benahili U Iboaya, DO

  • Nephrology Physician
  • Findlay, OH
  • NPI 1699755876

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1558985663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 PELICAN WAY",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334838011",
            "telephone_number": "513-673-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 E WYANDOT AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433519647",
            "telephone_number": "513-673-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYANDOT DIALYSIS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "FRITZSCH",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "513-673-5245",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1207 E Wyandot Ave",
            "city": "Upper Sandusky",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433519647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wyandot County Board of DD
• Wyandot County Council on Aging, Inc.
• Wyandot County Office of Auditor (Wyandot County Health Department)
• Wyandot County Office of Auditor (Wyandot County EMS)
• Wyandot County Office of Auditor (Wyandot County Skilled Nursing & Rehabilitation Center)
• Wyandot Memorial Hospital
• Wyandot Memorial Hospital
• Wyandot Memorial Hospital (Wyandot Memorial Home Health and Hospice)
• Wyandot Memorial Hospital
• Wyandot Memorial Hospital (Wyandot Memorial Home Health and Hospice)

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Upper Sandusky, OH
• Providers in Upper Sandusky, OH by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.