NPIMap

Organization Active NPI

Renal Treatment Centers-Illinois Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pontiac, MI
National Provider Identifier
1588042857
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
RENAL TREATMENT CENTERS-ILLINOIS INC
Practice address
450 N Telegraph Rd Ste 600
Pontiac, MI 48341-1037
Phone
(248) 333-2230
Fax
(248) 333-9589
NPI assigned
May 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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 Primary

Addresses

Primary practice location

450 N Telegraph Rd Ste 600
Pontiac, MI 48341-1037

Mailing address

5200 Virginia Way
Brentwood, TN 37027-7569
Phone (615) 320-4514

Other identifiers 1

IdentifierTypeStateIssuer
1619938131MedicaidMI

Other names 1

  • North Oakland Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150718000171 MI Part A Provider - End-Stage Renal Disease Facility (ESRD) 2365359965 Practice locations: Pontiac, MI

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita North Oakland DialysisCCN 232511
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Oct 14, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
36

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
23D0718059North Oakland Dialysis450 N Telegraph Road Suite 600, Pontiac, MI 48341Certificate of waiverNov 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
Renal Treatment Centers - Illinois Inc85 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

Locations

450 N Telegraph Rd
Pontiac, MI 48341
Phone (248) 333-2230

450 N Telegraph Rd
Ste 600
Pontiac, MI 48341
Phone (248) 333-2230

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1588042857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4514",
            "fax_number": "866-594-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N TELEGRAPH RD STE 600",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411037",
            "telephone_number": "248-333-2230",
            "fax_number": "248-333-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS-ILLINOIS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2022-11-01",
        "certification_date": "2022-10-28",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619938131",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Oakland Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Oakland Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.