NPIMap

Organization Active NPI

Red Rocks Dialysis, LLC

Doing business as U.S Renal Care Gallup PD Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Gallup, NM
National Provider Identifier
1780915298
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
RED ROCKS DIALYSIS, LLC
Doing business as
U.S Renal Care Gallup PD Dialysis
Practice address
1801 Red Rock Dr
Gallup, NM 87301-5655
Phone
(505) 863-7257
NPI assigned
Jan 22, 2010
Last updated
Aug 22, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
U.S. RENAL CARE, INC..As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Authorized official

Name
Thomas L. Weinberg
Title
Authorized Official
Phone
(214) 736-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

1801 Red Rock Dr
Gallup, NM 87301-5655

Mailing address

1 World Trade Ctr
Ste 2500
Long Beach, CA 90831-0002
Phone (562) 495-8075

Other identifiers 1

IdentifierTypeStateIssuer
74288270MedicaidNM

Other names 1

  • U.S Renal Care Gallup PD Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100129000614 NM Part A Provider - End-Stage Renal Disease Facility (ESRD) 8325196066 Practice locations: Gallup, NM

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Usrc Gallup HomeCCN 322540
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Sep 16, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Chain
US Renal Care, Inc.
Dialysis stations
3

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2004223Red Rocks Dialysis LLC Dba U S Renal Care Gallup1801 Red Rock Drive, Gallup, NM 87301Certificate of waiverFeb 29, 2028

National Provider Directory

National Provider Directory
Tax ID family
Red Rocks Dialysis LLC4 organizations share this tax ID, including this one
Part of
US Renal Care Inc

Other organizations with this tax ID 3

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

Locations

1910 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7041

1910 Red Rock Dr
Ste B
Gallup, NM 87301
Phone (505) 863-7257

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

Affiliated clinicians 5

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

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1780915298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WORLD TRADE CTR",
            "address_2": "STE 2500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908310002",
            "telephone_number": "562-495-8075",
            "fax_number": "562-495-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 RED ROCK DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015655",
            "telephone_number": "505-863-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED ROCKS DIALYSIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC..",
        "enumeration_date": "2010-01-22",
        "last_updated": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "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": "74288270",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S Renal Care Gallup PD Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.