Plover Dialysis LLC

Primary specialty

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

Legal business name

PLOVER DIALYSIS LLC

Doing business as

Wyoming Street Dialysis

Practice address

13945 Wyoming St
Detroit, MI 48238-2333

Phone

(313) 931-2954

Fax

(313) 931-3084

NPI assigned

Feb 7, 2018

Last updated

Jun 17, 2025By the provider in NPPES

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• Wyoming Street Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

DaVita Wyoming Street DialysisCCN 232738

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Apr 1, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

13

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.

• Nephro-Care MD PLC

  • Nephrology Physician
  • Detroit, MI
  • NPI 1336510072

  Member Of

  NPD member
• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member

Locations

Affiliated clinicians 2

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

• Yousef Bader, MD, MS

  • Nephrology Physician
  • Southfield, MI
  • NPI 1174050231

  Dialysis facility

  Care Compare affiliation Name & address match
• Chadi Youssef Saad, MD

  • Nephrology Physician
  • Detroit, MI
  • NPI 1114193646

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1740789536",
    "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": "37027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13945 WYOMING ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482382333",
            "telephone_number": "313-931-2954",
            "fax_number": "313-931-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLOVER DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-07",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740789536",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyoming Street Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wyoming Street Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lydia Plencner, RN
• Devon Lee Plewman, MD
• Plexus Gastro PLLC
• Richard Arthur Plezia, DDS
• Elizabeth Christine Plonka, NONE
• PND Comfort Solutions LLC
• Podiatry Examiners of Michigan PC
• Addie M Poe, NURSE
• Sophia Poelker
• Poem Humanservice Development Corp.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.