Mendocino Dialysis LLC

Primary specialty

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

Legal business name

MENDOCINO DIALYSIS LLC

Doing business as

North Conroe Dialysis

Practice address

3211 Interstate 45 N Ste 500
Conroe, TX 77304-2187

Phone

(936) 756-9400

Fax

(936) 756-9450

NPI assigned

May 16, 2011

Last updated

Jul 29, 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 Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Conroe Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

DaVita North Conroe DialysisCCN 672717

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Oct 30, 2013

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

16

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 1

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

• Renal Treatment Centers-Southeast, LP.

  dba Barbour County Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Eufaula, AL
  • NPI 1326583188

  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.

• Naqi Idris, M.D.

  • Internal Medicine Physician
  • Mesquite, TX
  • NPI 1659562627
  NPD (past)

Affiliated clinicians 5

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

• Adam Immanuel Frome, MD

  • Nephrology Physician
  • The Woodlands, TX
  • NPI 1215124417

  Dialysis facility

  Care Compare affiliation Name & address match
• Shahzeb Raza Naqvi, M.D.

  • Nephrology Physician
  • Shenandoah, TX
  • NPI 1346287448

  Dialysis facility

  Care Compare affiliation Name & address match
• Darshan Vipin Tolat, M.D.

  • Nephrology Physician
  • Conroe, TX
  • NPI 1063418515

  Dialysis facility

  Care Compare affiliation Name & address match
• Michael James Walls, M.D.

  • Specialist
  • Conroe, TX
  • NPI 1679579791

  Dialysis facility

  Care Compare affiliation Name & address match
• Syed M Zaidi, M.D.

  • Nephrology Physician
  • Conroe, TX
  • NPI 1912090572

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1770875395",
    "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": "3211 INTERSTATE 45 N STE 500",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042187",
            "telephone_number": "936-756-9400",
            "fax_number": "936-756-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDOCINO DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": "3356958-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Conroe Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Conroe Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Memorial Hermann Health System (Memorial Hermann Imaging Centers-Conroe Center RR)
• Memorial Hermann Health System (Memorial Hermann Imaging Centers-Conroe Center)
• Jeffrey P. Mendillo, LCSW
• Mending Peace and Purpose Mental Health Services PLLC
• Mending Peace and Purpose Mental Health Services PLLC
• Christopher Mendoza, MD
• Louise Nicolette Alcantara Mendoza
• Maegan Mendoza
• Natalie Louise Mendoza
• Gwendoline Ngankeu Menga, DO

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Conroe, TX
• Providers in Conroe, 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 Jul 29, 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.