Organization Active NPI

Rophets Dialysis LLC

Doing business as Vista Heights Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Moreno Valley, CA
National Provider Identifier
1730631045
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
ROPHETS DIALYSIS LLC
Doing business as
Vista Heights Dialysis
Practice address
12220 Perris Blvd
Ste a
Moreno Valley, CA 92557-7417
Phone
(951) 242-5112
Fax
(951) 242-9913
NPI assigned
Nov 3, 2016
Last updated
Oct 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Samuel T. Wey
Title
VP, Licensure & Certification
Phone
(615) 341-6641

Specialties & licenses 1

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

Addresses

Primary practice location

12220 Perris Blvd
Ste a
Moreno Valley, CA 92557-7417

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
1730631045MedicaidCA

Other names 1

  • Vista Heights Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161130001751 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 2264712660 Practice locations: Moreno Valley, CA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Vista Heights Dialysis CenterCCN 552846
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Sep 24, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
37

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
05D2153329Vista Heights Dialysis12220 Perris Blvd Ste a, Moreno Valley, CA 92557Certificate of waiverAug 23, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

12220 Perris Blvd
Moreno Valley, CA 92557

12220 Perris Blvd
#A
Moreno Valley, CA 92557
Phone (951) 242-5112

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1478131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1730631045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12220 PERRIS BLVD",
            "address_2": "STE A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577417",
            "telephone_number": "951-242-5112",
            "fax_number": "951-242-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROPHETS DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-03",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "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": "1730631045",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Heights Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vista Heights Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.