NPIMap

Organization Active NPI

Christus Santa Rosa Health Care Corporation

Doing business as CHRISTUS Children's Kidney Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Antonio, TX
National Provider Identifier
1861415903
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
007807 Issued in TX
Legal business name
CHRISTUS SANTA ROSA HEALTH CARE CORPORATION
Doing business as
CHRISTUS Children's Kidney Center
Practice address
333 N Santa Rosa St
San Antonio, TX 78207-3108
Phone
(210) 704-3705
Fax
(210) 704-3777
NPI assigned
Jul 26, 2006
Last updated
Aug 18, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CHRISTUS SANTA ROSA HEALTH CARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Authorized official

Name
Cris Daskevich
Title
Ceo
Phone
(210) 704-4899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 007807 TX Primary

Addresses

Primary practice location

333 N Santa Rosa St
San Antonio, TX 78207-3108

Mailing address

PO Box 846131
Dallas, TX 75284-6131
Phone (800) 756-7999

Other identifiers 1

IdentifierTypeStateIssuer
154536001MedicaidTX

Other names 1

  • CHRISTUS Children's Kidney Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030428000039 TX Part A Provider - End-Stage Renal Disease Facility (ESRD) 6204745094 Practice locations: San Antonio, TX

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Christus Childrens Kidney CenterCCN 452372
Ownership
Non-profit
Certified
Jul 1, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
8

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

National Provider Directory

National Provider Directory
Part of
Santa Rosa Downtown Ekg

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1861415903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846131",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846131",
            "telephone_number": "800-756-7999",
            "fax_number": "469-282-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-3705",
            "fax_number": "210-704-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTUS SANTA ROSA HEALTH CARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTUS SANTA ROSA HEALTH CARE CORPORATION",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "DASKEVICH",
        "authorized_official_first_name": "CRIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "210-704-4899"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "007807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154536001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS Children's Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHRISTUS Children's Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.