Physicians Choice Dialysis of Alabama LLC

Primary specialty

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

License

S5103 Issued in AL

Legal business name

PHYSICIANS CHOICE DIALYSIS OF ALABAMA LLC

Practice address

1001 Forest Avenue
Montgomery, AL 36106

Phone

(334) 269-9416

Fax

(334) 269-0024

NPI assigned

Apr 13, 2006

Organization subpart

No

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

Authorized official

Name

John Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Physicians Choice Dialysis - Montgomery Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Physicians Choice Dialysis of Alabama LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Wetumpka, AL
  • NPI 1063476489

  0446161095

  Same PAC ID
• Physicians Choice Dialysis of Alabama LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Prattville, AL
  • NPI 1902860331

  0446161095

  Same PAC ID

Listed as

DaVita PDI-MontgomeryCCN 012505

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Dec 14, 1977

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

19

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

CLIA laboratory certificates

Tax ID family

Physicians Choice Dialysis of Alabama LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Physicians Choice Dialysis of Alabama LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Wetumpka, AL
  • NPI 1063476489
  NPD tax ID
• Physicians Choice Dialysis of Alabama LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Prattville, AL
  • NPI 1902860331
  NPD tax ID

Affiliated clinicians 2

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

• Apoorv Deotare, MD

  • Nephrology Physician
  • Montgomery, AL
  • NPI 1487149134

  Dialysis facility

  Care Compare affiliation Name & address match
• Sumeet Munjal, MD

  • Nephrology Physician
  • Montgomery, AL
  • NPI 1578819546

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597363200000",
    "number": "1760446199",
    "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",
            "telephone_number": "615-320-4268",
            "fax_number": "877-238-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 FOREST AVENUE",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36106",
            "telephone_number": "334-269-9416",
            "fax_number": "334-269-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CHOICE DIALYSIS OF ALABAMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "AL",
            "license": "S5103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760446199",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Choice Dialysis - Montgomery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physicians Choice Dialysis - Montgomery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justin Wesley Phillpott, M.D.
• Phoenix Rising Therapy
• Chethana R. Phonde, M.D.
• Chiangchanh Phothisane, PHARMD
• Chris H Phung, RPH
• Physicians Choice Dialysis of Alabama LLC
• Physicians Choice Dialysis of Montgomery LLC
• Physicians for Women
• Physicians Making House Calls, LLC
• Philip S Piasecki, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Montgomery, AL
• Providers in Montgomery, AL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.