Mesilla Dialysis LLC

Primary specialty

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

Legal business name

MESILLA DIALYSIS LLC

Doing business as

Midwest Urbana Dialysis

Practice address

1430 E US Highway 36
Urbana, OH 43078-9112

Phone

(937) 484-4600

Fax

(937) 484-4407

NPI assigned

Apr 14, 2010

Last updated

May 13, 2024By 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 T Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Midwest Urbana Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Listed as

DaVita Midwest Urbana DialysisCCN 362729

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Oct 23, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

12

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 2

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

• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member
• Total Renal Care, Inc.

  dba Bountiful Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bountiful, UT
  • NPI 1184387516

  Member Of

  NPD member

Affiliated clinicians 4

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

• Adeleye A. Edon, DO

  • Nephrology Physician
  • London, OH
  • NPI 1306105804

  Dialysis facility

  Care Compare affiliation Name & address match
• Pius Kurian, MD

  • Nephrology Physician
  • Springfield, OH
  • NPI 1174516652

  Dialysis facility

  Care Compare affiliation Name & address match
• M. Ahsan Ullah, M.D.

  • Nephrology Physician
  • Springfield, OH
  • NPI 1275538480

  Dialysis facility

  Care Compare affiliation Name & address match
• Sanju Andrew Varghese, MD

  • Nephrology Physician
  • Springfield, OH
  • NPI 1780629956

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1831415918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: 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": "1430 E US HIGHWAY 36",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430789112",
            "telephone_number": "937-484-4600",
            "fax_number": "937-484-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESILLA DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-14",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3089090",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Urbana Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Midwest Urbana Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meaningful Believable Solutions LLC
• Terry Means, LSW
• Mercy Health Physicians Springfield Primary Care LLC
• Mercy Medical Associates, LLC
• Heather Mershon, LPN
• Joseph M Metz, M.D.
• Mark Conrad Miller, LISW
• Mutahher Ibraze Mohammed
• Marion F Monroe
• Ruth Eileen Montgomery, LISW-S

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Urbana, OH
• Providers in Urbana, OH by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.