Gramleer Dialysis LLC
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Joppa, MD
NPI 1578083648 · NPPES record last updated Dec 17, 2025
Key facts
- NPI
- 1578083648
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- GRAMLEER DIALYSIS LLC
- Practice address
- 1415 S Mountain Rd Ste 105
Joppa, MD 21085-3236 - Phone
- (410) 671-6059
- Fax
- (410) 612-9206
- NPI assigned
- Jun 21, 2017
- Organization subpart
- No
Authorized official
- Name
- Samuel T Wey
- Title
- VP, Licensure & Certification
- Phone
- (615) 341-6641
Member of 1
Affiliated clinicians 3
-
Nasha Elavia, MD
-
Mohamad Hanouneh, M.D
Medicare Care Compare: Dialysis facility
- Listed as
- DaVita Edgewood Dialysis
- Overall star rating
- ★★★☆☆ 3.0 of 5
- Ownership
- Profit
- Certified
- Jun 25, 2018
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 16
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2144297 | Edgewood Dialysis | Certificate of waiver | Feb 13, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180112000565 | MD | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 9032478342 | Practice locations: Joppa, MD |
National Provider Directory
Locations
1415 S Mountain Rd
#105
Joppa, MD 21085
Phone (410) 671-6059
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
1415 S Mountain Rd Ste 105
Joppa, MD 21085-3236
Mailing address
5200 Virginia Way
Brentwood, TN 37027-7569
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 700183500 | Medicaid | MD |
Other names
- Edgewood Dialysis
Other providers in Joppa, MD
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- Good Morning Health Care
- Dianne Goodman
- Jay Gould
- Isabella Victoria Gray
- Casey Marie Green
- Jessica Mahla Griffin
- Christine Marie Guay
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All providers in Joppa, MD · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.