Animas Dialysis LLC

Primary specialty

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

License

930000882 Issued in CA

Legal business name

ANIMAS DIALYSIS LLC

Doing business as

Doctors Dialysis Center of Montebello

Practice address

1721 W Whittier Blvd
Montebello, CA 90640-4004

Phone

(323) 722-1116

Fax

(323) 722-5501

NPI assigned

Feb 11, 2009

Last updated

Dec 20, 2023By 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 identifiers 1

Other names 1

• Doctors Dialysis Center of Montebello Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Animas Dialysis LLC

  dba Doctors Dialysis of East Los Angeles

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
  • NPI 1083853667

  6507915857

  Same PAC ID

Tax ID family

Animas Dialysis LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Animas Dialysis LLC

  dba Doctors Dialysis of East Los Angeles

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
  • NPI 1083853667
  NPD tax ID

Member of 2

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

• Total Renal Care Inc

  dba TRC Children's Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chicago, IL
  • NPI 1396704508

  Member Of

  NPD member
• Total Renal Care Inc

  dba Bay City Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bay City, MI
  • NPI 1760759864

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1568601789",
    "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": "1721 W WHITTIER BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404004",
            "telephone_number": "323-722-1116",
            "fax_number": "323-722-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANIMAS DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "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": "CA",
            "license": "930000882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156601789",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Dialysis Center of Montebello",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Doctors Dialysis Center of Montebello",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Montebello, CA
• Providers in Montebello, 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 Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.