NPIMap

Organization Active NPI

Dialysis Clinic Inc

Doing business as Dialysis Clinic Inc - Southwest Mesa

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1710406301
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DIALYSIS CLINIC INC
Doing business as
Dialysis Clinic Inc - Southwest Mesa
Practice address
8121 Central Ave NW
Albuquerque, NM 87121-2125
Phone
(505) 836-1061
Fax
(505) 836-8644
NPI assigned
Sep 14, 2017
Last updated
Oct 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Mr. Donovan Schultz
Title
President
Phone
(615) 327-3061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

8121 Central Ave NW
Albuquerque, NM 87121-2125

Mailing address

1500 Indian School Rd NE
Albuquerque, NM 87102-1646
Phone (505) 724-1500

Other names 1

  • Dialysis Clinic Inc - Southwest Mesa Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171024000297 NM Part A Provider - End-Stage Renal Disease Facility (ESRD) 4284541129 Practice locations: Albuquerque, NM

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
322558-Albuquerque Southwest MesaCCN 322558
Overall star rating
4.0 of 5
Ownership
Non-profit
Certified
Aug 8, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Dialysis Clinic, Inc.
Dialysis stations
20

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
32D2145853Dialysis Clinic Inc - West8121 Central Ave NW, Albuquerque, NM 87121Certificate of waiverMar 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
Dialysis Clinic Inc238 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 11

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

8121 Central Ave NW
Albuquerque, NM 87121
Phone (505) 836-1061

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rancho Dialysis ClinicSacramento, CA, CCN 552519 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 24, 2003
Dec 24, 2003

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1505347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1710406301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 INDIAN SCHOOL RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021646",
            "telephone_number": "505-724-1500",
            "fax_number": "505-724-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8121 CENTRAL AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871212125",
            "telephone_number": "505-836-1061",
            "fax_number": "505-836-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-14",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-327-3061",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "Dialysis Clinic Inc - Southwest Mesa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.