Organization Active NPI

Dialysis Access Center a Medical Corporation

  • Ambulatory Surgical Clinic/Center
  • Oakland, CA
National Provider Identifier
1760923445
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
DIALYSIS ACCESS CENTER A MEDICAL CORPORATION
Practice address
3012 Summit St
D Wing
Oakland, CA 94609-3480
Phone
(510) 251-1002
NPI assigned
Mar 15, 2017
Last updated
Sep 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Authorized official

Name
Brett Wiley
Title
Authorized Official
Phone
(510) 251-1002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

3012 Summit St
D Wing
Oakland, CA 94609-3480

Mailing address

PO Box 883528
Los Angeles, CA 90088-3528
Phone (510) 251-1002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170607001272 CA Part B Supplier - Ambulatory Surgical Center 2062400443 Practice locations: Oakland, CA

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Dialysis Access Center a Medical CorporationCCN 05C0002166
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

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

Locations

3012 Summit St
#D
Oakland, CA 94609
Phone (510) 251-1002

3012 Summit St
Ste D
Oakland, CA 94609

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1760923445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 883528",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900883528",
            "telephone_number": "510-251-1002",
            "fax_number": "510-251-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 SUMMIT ST",
            "address_2": "D WING",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093480",
            "telephone_number": "510-251-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS ACCESS CENTER A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-15",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "510-251-1002"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.