Star Dialysis LLC

Primary specialty

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

License

17-0097 Issued in OR

Legal business name

STAR DIALYSIS LLC

Doing business as

Grants Pass II Dialysis

Practice address

1055 Redwood Ave
Grants Pass, OR 97527-5525

Phone

(541) 479-0545

Fax

(541) 479-4271

NPI assigned

Jun 15, 2013

Last updated

Sep 30, 2025By 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

• Grants Pass II Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

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

• Star Dialysis LLC

  dba Siskiyou Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Medford, OR
  • NPI 1265993620

  3375699804

  Same PAC ID
• Star Dialysis LLC

  dba Rogue Valley Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Medford, OR
  • NPI 1306077680

  3375699804

  Same PAC ID
• Star Dialysis LLC

  dba Redwood Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Grants Pass, OR
  • NPI 1720219017

  3375699804

  Same PAC ID

Listed as

DaVita Grants Pass II DialysisCCN 382565

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Oct 29, 2013

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

Tax ID family

Grants Pass II Dialysis4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Star Dialysis LLC

  dba Siskiyou Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Medford, OR
  • NPI 1265993620
  NPD tax ID
• Star Dialysis LLC

  dba Rogue Valley Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Medford, OR
  • NPI 1306077680
  NPD tax ID
• Star Dialysis LLC

  dba Redwood Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Grants Pass, OR
  • NPI 1720219017
  NPD tax ID

Member of 2

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

• Renal Care Consultants PC

  dba Rogue Valley Dialysis Services

  • Renal Dialysis Technician
  • Medford, OR
  • NPI 1972594059

  Member Of

  NPD member
• Total Renal Care Inc

  dba Cerritos Dialysis

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

  Member Of

  NPD member

Affiliated clinicians 1

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

• Kumar Pannagasayanam Dinesh, MD

  • Specialist
  • Medford, OR
  • NPI 1225222599

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1371254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1952740672",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 REDWOOD AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275525",
            "telephone_number": "541-479-0545",
            "fax_number": "541-479-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-15",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "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": "OR",
            "license": "17-0097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500669206",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grants Pass II Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grants Pass II Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Gardner Stahlman
• Serena Teresa Stanger, LAP
• John G Stanko, PA-C
• Laura Stansfield
• Star Dialysis LLC (Redwood Dialysis)
• Dusti Stark
• Laura Marlene Starr
• Alahna Staten
• Michelle Staton, PA-C
• Michael F Stattel, LPC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.