NPIMap

Organization Active NPI

Dva Healthcare of Massachusetts Inc

Doing business as New Bedford Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • North Dartmouth, MA
National Provider Identifier
1962461988
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
EHKF Issued in MA
Legal business name
DVA HEALTHCARE OF MASSACHUSETTS INC
Doing business as
New Bedford Dialysis
Practice address
237-B State Rd
North Dartmouth, MA 02747-2612
Phone
(508) 992-0629
Fax
(508) 999-1319
NPI assigned
Mar 20, 2006
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X EHKF MA Primary

Addresses

Primary practice location

237-B State Rd
North Dartmouth, MA 02747-2612

Mailing address

5200 Virginia Way
Att: L&C Dept
Brentwood, TN 37027-7569
Phone (615) 320-4214

Other identifiers 2

IdentifierTypeStateIssuer
4102530MedicaidRI
1311379MedicaidMA

Other names 1

  • New Bedford Dialysis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030424000021 MA Part A Provider - End-Stage Renal Disease Facility (ESRD) 9830007202 Practice locations: North Dartmouth, MA

Other NPIs with the same Medicare PAC ID 9

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita New Bedford DialysisCCN 222530
Overall star rating
4.0 of 5
Ownership
Profit
Certified
Jan 6, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
22

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0900276New Bedford Dialysis237-B State Road, Dartmouth, MA 02747Certificate of waiverApr 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dva Healthcare of Massachusetts Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Member of 1

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

Locations

237 State Rd
#B
North Dartmouth, MA 02747
Phone (508) 994-9692

237B State Rd
North Dartmouth, MA 02747
Phone (508) 992-0629

Practitioners & 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": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1962461988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4214",
            "fax_number": "866-944-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237-B STATE RD",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027472612",
            "telephone_number": "508-992-0629",
            "fax_number": "508-999-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE OF MASSACHUSETTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-25",
        "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": "MA",
            "license": "EHKF",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4102530",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1311379",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Bedford Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New Bedford Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Dartmouth, MA

Sources for this page

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

Verify at the official NPI Registry.