Fresenius Medical Care Lamesa, LLC

Primary specialty

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

Legal business name

FRESENIUS MEDICAL CARE LAMESA, LLC

Doing business as

Fresenius Kidney Care Stanbaugh Memorial

Practice address

1600 N Bryan Ave
Lamesa, TX 79331-3145

Phone

(806) 872-9239

Fax

(806) 872-3524

NPI assigned

Jan 31, 2018

Last updated

Oct 20, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

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

Authorized official

Name

Barry L. Blanton

Title

Vice President

Phone

(781) 699-9000

Specialties & licenses 1

Addresses

Other names 1

• FRESENIUS KIDNEY CARE STANBAUGH MEMORIAL Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740788124. Details of each certification follow.

• CCN 742520 End-stage renal disease facility · Active · Name & address match · Details

End-stage renal disease facility certification: CCN 742520

Legal name

FRESENIUS KIDNEY CARE STANBAUGH MEMORIAL

Certification status

Active

Provider type (POS)

End-stage renal disease facility

Participating since

Jan 22, 2019

Last certification

Oct 16, 2024

Ownership / control type

For Profit

Multi-facility organization

FMC

Facility address

1600 North Bryan Avenue
Lamesa, TX 79331

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

CLIA laboratory certificates

Member of 2

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

• Bio-Medical Applications of Texas, Inc.

  dba Fresenius Kidney Care Woodland West

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Magnolia, TX
  • NPI 1457808776

  Member Of

  NPD member
• National Medical Care, Inc.

  dba RCC Wellington

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lake Worth, FL
  • NPI 1871695163

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elmoutaz Tawfig Mousa, M.D.

  • Nephrology Physician
  • Lubbock, TX
  • NPI 1124287735
  NPD (past)

Affiliated clinicians 2

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

• Maybin Simfukwe, MD

  • Nephrology Physician
  • Lubbock, TX
  • NPI 1689635559

  Dialysis facility

  Care Compare affiliation Name & address match
• Leo Takashi Yamaguchi, MD

  • Nephrology Physician
  • Lubbock, TX
  • NPI 1467912709

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1740788124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N BRYAN AVE",
            "city": "LAMESA",
            "state": "TX",
            "postal_code": "793313145",
            "telephone_number": "806-872-9239",
            "fax_number": "806-872-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N BRYAN AVE",
            "city": "LAMESA",
            "state": "TX",
            "postal_code": "793313145",
            "telephone_number": "806-872-9239",
            "fax_number": "806-872-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE LAMESA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2018-01-31",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "BLANTON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "FRESENIUS KIDNEY CARE STANBAUGH MEMORIAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• El Paso Sunny Hills Family Dental, PLLC
• Amy Leigh Elliott, FNP-BC
• Tegegne Fenta
• Fpacp Lamesa LLC
• Joshua Klaus Freitag, PT, DPT
• Anthony Gipson, M.D.
• Griengsak Chowpaknam MD PA
• Dolly Kay Gutierrez, RN, MSN, FNP-C
• Olga Casarez Gutierrez, LVN
• Kiflemariam Haile, PHARMACIST

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Lamesa, TX
• Providers in Lamesa, 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 Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.