Physicians Choice Dialysis of Alabama LLC

Primary specialty

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

License

S0101 Issued in AL

Legal business name

PHYSICIANS CHOICE DIALYSIS OF ALABAMA LLC

Practice address

600 McQueen Smith Rd S
Prattville, AL 36066-5716

Phone

(334) 581-1576

Fax

(334) 358-2139

NPI assigned

Apr 13, 2006

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

• Physicians Choice Dialysis-Prattville Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

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).

• Physicians Choice Dialysis of Alabama LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Wetumpka, AL
  • NPI 1063476489

  0446161095

  Same PAC ID
• Physicians Choice Dialysis of Alabama LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Montgomery, AL
  • NPI 1760446199

  0446161095

  Same PAC ID

Listed as

DaVita PDI-PrattvilleCCN 012535

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Jan 26, 1990

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

16

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

Physicians Choice Dialysis of Alabama LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Physicians Choice Dialysis of Alabama LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Wetumpka, AL
  • NPI 1063476489
  NPD tax ID
• Physicians Choice Dialysis of Alabama LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Montgomery, AL
  • NPI 1760446199
  NPD tax ID

Locations

Affiliated clinicians 2

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

• Sumeet Munjal, MD

  • Nephrology Physician
  • Montgomery, AL
  • NPI 1578819546

  Dialysis facility

  Care Compare affiliation Name & address match
• Jogy Varghese, M.D.

  • Nephrology Physician
  • Montgomery, AL
  • NPI 1841380284

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1902860331",
    "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": "615-320-4268",
            "fax_number": "877-238-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MCQUEEN SMITH RD S",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665716",
            "telephone_number": "334-581-1576",
            "fax_number": "334-358-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CHOICE DIALYSIS OF ALABAMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "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": "AL",
            "license": "S0101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DIA2535D",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Choice Dialysis-Prattville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Prattville, AL
• Providers in Prattville, AL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Alabama

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