Keystone Dialysis LLC

Primary specialty

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

Legal business name

KEYSTONE DIALYSIS LLC

Practice address

4180 Hospital Dr
East China, MI 48054-2232

Phone

(810) 326-0032

Fax

(810) 326-0151

NPI assigned

Aug 5, 2015

Organization subpart

No

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

Authorized official

Name

John Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• East China Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

DaVita East China DialysisCCN 232718

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 28, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

13

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

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Napa, CA
  • NPI 1295024206

  Member Of

  NPD member
• 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.

• Saurabh Gandhi, D.O.

  • Nephrology Physician
  • Shelby Township, MI
  • NPI 1093032021

  Dialysis facility

  Care Compare affiliation Name & address match
• Eric Krutel, D.O.

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1144773284

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1871979492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPARTMENT",
            "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": "4180 HOSPITAL DR",
            "city": "EAST CHINA",
            "state": "MI",
            "postal_code": "480542232",
            "telephone_number": "810-326-0032",
            "fax_number": "810-326-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-05",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "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": "1871979492",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East China Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East China Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Janelle Horvath, RN
• Matthew Hulst, OD
• Bridget Jablinskey, MPT
• Randall Peter Kamlay, OD
• Kenneth MD PLC
• Charles W. Killewald, R.PH.
• Patricia Kindsvater, MD
• Lisa Sue Koehn, MSW, CSW
• Laura Lucio-Reincke, PLLC
• Sherice Letarte

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in East China, MI
• Providers in East China, 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 Dec 14, 2020; 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.