Liberty Dialysis - Duncanville LLC

Primary specialty

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

Legal business name

LIBERTY DIALYSIS - DUNCANVILLE LLC

Practice address

1038 US Highway 67
Duncanville, TX 75137-2704

Phone

(214) 302-0238

NPI assigned

Aug 7, 2007

Organization subpart

Yes

Parent organization

U.S. RENAL CARE INCAs reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

President & Chairman

Phone

(214) 736-2730

Specialties & licenses 1

Addresses

Other names 1

• Premier Dialysis - Duncanville Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

USRC Premier DuncanvilleCCN 672600

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Jul 3, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

21

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

CLIA laboratory certificates

Part of

US Renal Care Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• U.S. Renal Care, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Plano, TX
  • NPI 1588581870
  NPPES parent name

Practitioners 1

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

• Yugandhar P Chimata, MD

  • Nephrology Physician
  • Desoto, TX
  • NPI 1548299480
  NPD (past)

Affiliated clinicians 2

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

• Ratna S Danda, MD

  • Nephrology Physician
  • Desoto, TX
  • NPI 1467481382

  Dialysis facility

  Care Compare affiliation Name & address match
• Latha Velusamy, M.D.

  • Nephrology Physician
  • Dallas, TX
  • NPI 1710986013

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1639360209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844631",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844631",
            "telephone_number": "214-736-2700",
            "fax_number": "214-736-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1038 US HIGHWAY 67",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751372704",
            "telephone_number": "214-302-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS - DUNCANVILLE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE INC",
        "enumeration_date": "2007-08-07",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT & CHAIRMAN",
        "authorized_official_telephone_number": "214-736-2730"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Dialysis - Duncanville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Duncanville, TX
• Providers in Duncanville, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.