Lassen Dialysis LLC

Primary specialty

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

Legal business name

LASSEN DIALYSIS LLC

Practice address

18100 Oakwood Blvd
Ste 206
Dearborn, MI 48124-4085

Phone

(313) 438-7959

Fax

(313) 438-7960

NPI assigned

Apr 15, 2014

Organization subpart

No

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

Authorized official

Name

Samuel T Wey

Title

Sr Director Licensure&Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oakwood Renal Services Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

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).

• Lassen Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Riverview, MI
  • NPI 1497010474

  3870741721

  Same PAC ID
• Lassen Dialysis, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dearborn, MI
  • NPI 1619386489

  3870741721

  Same PAC ID

Listed as

DaVita Oakwood Renal ServicesCCN 232702

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Jul 1, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

18

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

Corewell Health Dearborn Hospital5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Dva Healthcare Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dearborn, MI
  • NPI 1689833956
  NPD tax ID
• Lassen Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Riverview, MI
  • NPI 1497010474
  NPD tax ID
• Lassen Dialysis, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dearborn, MI
  • NPI 1619386489
  NPD tax ID
• Oakwood Healthcare Inc

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1821310806
  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

  Member Of

  NPD member

Affiliated clinicians 2

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

• Kashif Majeed Chaudhry, MD

  • Internal Medicine Physician
  • Taylor, MI
  • NPI 1518905686

  Dialysis facility

  Care Compare affiliation Name & address match
• Sudheer R Ummadi, MD

  • Nephrology Physician
  • Allen Park, MI
  • NPI 1437118106

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1801215959",
    "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": "615-320-4514",
            "fax_number": "866-594-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18100 OAKWOOD BLVD",
            "address_2": "STE 206",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244085",
            "telephone_number": "313-438-7959",
            "fax_number": "313-438-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASSEN DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SR DIRECTOR LICENSURE&CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801215959",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakwood Renal Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oakwood Renal Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lloyd Wade Lariscy, DDS
• Jessica Nicole Laroy
• Jose Ramil Lasala, ACNP-BC
• Lasik Centers of Michigan PC
• Marilyn Lasovage, M.D.
• Lassen Dialysis, LLC
• Sydney Lassen, PA-C
• Stephanie Latka, LLPC
• Lawrence G Morawa MD PC
• Lawrence S Mintzer DDS PLLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Dearborn, MI
• Providers in Dearborn, MI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.