Active NPI
Ikidney Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Diego, CA
National Provider Identifier
1962259127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- IKIDNEY DIALYSIS
- Practice address
- 4660 El Cajon Blvd Ste 110
San Diego, CA 92115-4465 - Phone
- (619) 781-7337
- NPI assigned
- May 3, 2024
- Last updated
- Aug 26, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Miss Margarette Gonzales, RN
- Title
- Facility Administrator
- Phone
- (619) 781-7337
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | NU | Primary |
Addresses
Primary practice location
4660 El Cajon Blvd Ste 110
San Diego, CA 92115-4465
Mailing address
4660 El Cajon Blvd Ste 110
San Diego, CA 92115-4465
Phone (619) 781-7337
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241008000478 | CA | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 4880130525 | Practice locations: San Diego, CA |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- iKidney Dialysis
- Ownership
- Profit
- Certified
- May 21, 2025
- Medicare certification status
- Active
- Dialysis stations
- 12
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 DirectoryPractitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714694400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724630400000",
"number": "1962259127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4660 EL CAJON BLVD STE 110",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921154465",
"telephone_number": "619-781-7337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4660 EL CAJON BLVD STE 110",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921154465",
"telephone_number": "619-781-7337"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IKIDNEY DIALYSIS",
"organizational_subpart": "NO",
"enumeration_date": "2024-05-03",
"last_updated": "2024-08-26",
"certification_date": "2024-08-20",
"status": "A",
"authorized_official_last_name": "GONZALES",
"authorized_official_first_name": "MARGARETTE",
"authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
"authorized_official_telephone_number": "619-781-7337",
"authorized_official_name_prefix": "Miss",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.