Pible Dialysis LLC | NPI 1750632592

Key facts

NPI: 1750632592
Entity type: Organization (NPI type 2)
Primary specialty: End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
License: 12Y763 (CO)
Legal business name: PIBLE DIALYSIS LLC
Practice address: 509 N Sable Blvd
Aurora, CO 80011
Phone: (303) 366-9458
Fax: (303) 364-9206
NPI assigned: Sep 19, 2012
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 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Pible Dialysis LLC End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Lakewood, CO · NPI 1134547383

Same PAC ID 2264689264

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Pible Dialysis LLC End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Lakewood, CO · NPI 1134547383

NPD tax ID

Member of 1

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

Total Renal Care Inc End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Burlington, WA · NPI 1932595584

NPD member Member Of

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CO

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20121129000360	CO	Part a Provider - End-Stage Renal Disease Facility (ESRD)	2264689264	Practice locations: Aurora, CO

National Provider Directory

Tax ID family: Pible Dialysis LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center	261QE0700X	12Y763	CO	Yes

Addresses

Primary practice location

509 N Sable Blvd
Aurora, CO 80011

Mailing address

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

Other identifiers

Identifier	Type	State	Issuer
1750632592	Medicaid	CO

Other names

Sable Dialysis Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 14, 2025.

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1750632592",
    "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": "509 N SABLE BLVD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80011",
            "telephone_number": "303-366-9458",
            "fax_number": "303-364-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIBLE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "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": "CO",
            "license": "12Y763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750632592",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sable Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sable Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, CO

All providers in Aurora, CO · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Colorado

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 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.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.