Physicians Dialysis of Lancaster, LLC
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Leola, PA
NPI 1710368261 · NPPES record last updated Oct 20, 2025
Key facts
- NPI
- 1710368261
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- PHYSICIANS DIALYSIS OF LANCASTER, LLC
- Practice address
- 345 W Main St
Ste 202
Leola, PA 17540-2108 - Phone
- (717) 556-0080
- Fax
- (717) 556-0085
- NPI assigned
- Jun 10, 2015
- Organization subpart
- No
Authorized official
- Name
- Samuel T. Wey
- Title
- VP Licensure & Certification
- Phone
- (615) 341-6641
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 5
Affiliated clinicians 1
-
Dean Campbell, MD
Medicare Care Compare: Dialysis facility
- Listed as
- DaVita Leola Dialysis
- Overall star rating
- ★★★☆☆ 3.0 of 5
- Ownership
- Profit
- Certified
- Oct 1, 2015
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 13
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D2102344 | Leola Dialysis | Certificate of waiver | Sep 21, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150710000348 | PA | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 5193634608 | Practice locations: Leola, PA |
National Provider Directory
- Tax ID family
- Physicians Dialysis of Lancaster LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
345 W Main St
Ste 202
Leola, PA 17540-2108
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007375490011 | Medicaid | PA |
Other names
- Leola Dialysis
Other providers in Leola, PA
- Northern Lancaster County Medical Group
- Northern Lancaster County Medical Group
- Erica Ostrum
- Melody J Peck
- Pennsylvania Dental Partners, LLC
- Dietmar Pilz
- William E Poole III
- Devon Powell
- Monae S Rector
- Meghan Reeves
All providers in Leola, PA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 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.