Innovative Dialysis of Patterson LLC

Primary specialty

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

Legal business name

INNOVATIVE DIALYSIS OF PATTERSON LLC

Doing business as

U.S. Renal Care Patterson Dialysis

Practice address

1700 Keystone Pacific Pkwy
Suite a-1
Patterson, CA 95363-8874

Phone

(209) 690-3768

NPI assigned

Apr 7, 2014

Last updated

Mar 27, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

SVP/Genera Counsel

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• U.S. Renal Care Patterson Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Usrc Patterson DialysisCCN 552768

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Oct 28, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

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

Part of

US Renal Care Inc

Affiliated clinicians 3

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

• Yuqiang Ge, M.D., PHD

  • Nephrology Physician
  • Modesto, CA
  • NPI 1740588680

  Dialysis facility

  Care Compare affiliation Name & address match
• Ripudaman Singh Munjal, M.D.

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1871900753

  Dialysis facility

  Care Compare affiliation Name & address match
• Tong Sun, MD

  • Nephrology Physician
  • Modesto, CA
  • NPI 1629161336

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1942629977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 DALLAS PKWY",
            "address_2": "SUITE 350",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 KEYSTONE PACIFIC PKWY",
            "address_2": "SUITE A-1",
            "city": "PATTERSON",
            "state": "CA",
            "postal_code": "953638874",
            "telephone_number": "209-690-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE DIALYSIS OF PATTERSON LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2014-04-07",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SVP/GENERA COUNSEL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Patterson Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Desiree Marie Herrera
• Jessica Herrera
• David A. Hilburn, MD
• Rona Kaye Nagal Hillerman
• Miguel Ibarra, DDS
• Zaya Ismail
• Gwynderlyn Patreac Jenkins
• Christopher Evan Johnson, PT, DPT
• Sandra F Jones-Mendoza, LMFT
• Tiffany Julian

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Patterson, CA
• Providers in Patterson, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.