NPIMap

Organization Active NPI

Dva Healthcare Renal Care Inc

Doing business as Chinatown Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Francisco, CA
National Provider Identifier
1831163245
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
140000626 Issued in CA
Legal business name
DVA HEALTHCARE RENAL CARE INC
Doing business as
Chinatown Dialysis
Practice address
636 Clay St
San Francisco, CA 94111-2502
Phone
(415) 291-8992
Fax
(415) 291-8985
NPI assigned
Feb 14, 2006
Last updated
Aug 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Sam T Wey
Title
Sr Dir Licensure & Certification
Phone
(615) 341-6641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 140000626 CA Primary

Addresses

Primary practice location

636 Clay St
San Francisco, CA 94111-2502

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 238-3085

Other identifiers 1

IdentifierTypeStateIssuer
1831163245MedicaidCA

Other names 1

  • Chinatown Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030429000012 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 7517875545 Practice locations: San Francisco, CA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Chinatown DialysisCCN 052769
Overall star rating
5.0 of 5
Ownership
Profit
Certified
Sep 19, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
22

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
05D0906459Chinatown Dialysis636 Clay Street, San Francisco, CA 94111Certificate of waiverOct 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Community Dialysis Services194 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Member of 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1831163245",
    "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": "615-238-3085",
            "fax_number": "800-268-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CLAY ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941112502",
            "telephone_number": "415-291-8992",
            "fax_number": "415-291-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SR DIR LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "140000626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831163245",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chinatown Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chinatown Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.