Active NPI
Total Renal Care Inc
Doing business as St. Augustine Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- St Augustine, FL
National Provider Identifier
1962768242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- TOTAL RENAL CARE INC
- Doing business as
- St. Augustine Dialysis
- Practice address
- 264 Southpark Cir E
Saint Augustine, FL 32086-5137 - Phone
- (904) 808-0445
- Fax
- (904) 808-0446
- NPI assigned
- Apr 11, 2012
- Last updated
- Apr 18, 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
- Samuel T Wey
- Title
- VP, Licensure & Certification
- Phone
- (615) 341-6641
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | NU | Primary |
Addresses
Primary practice location
264 Southpark Cir E
Saint Augustine, FL 32086-5137
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007297200 | Medicaid | FL |
Other names 1
- St. Augustine Dialysis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120629000118 | FL | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 2365417888 | Practice locations: Saint Augustine, FL |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- DaVita St Augustine Dialysis
- Overall star rating
- Ownership
- Profit
- Certified
- Jan 10, 1996
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 18
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 Directory- Tax ID family
- Springdale Dialysis
Organizations with this tax ID in the same state 13
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Titus Landing Home Training
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Titusville, FL
- NPI 1972071868
-
dba Miami Lakes Artificial Kidney Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Miami Lakes, FL
- NPI 1790753507
-
dba Regency Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Jacksonville, FL
- NPI 1821291147
-
dba Memorial Plaza Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Jacksonville, FL
- NPI 1831477173
-
dba Sanford Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Sanford, FL
- NPI 1841438454
-
dba Lighthouse Point Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Deerfield Beach, FL
- NPI 1861469314
-
dba Pinnacle Dialysis of Boca Raton
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Boca Raton, FL
- NPI 1871748087
-
dba Hernando Kidney Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Spring Hill, FL
- NPI 1881661288
-
dba Miramar Kidney Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Miramar, FL
- NPI 1891003323
-
dba Pompano Beach Artificial Kidney Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Pompano Beach, FL
- NPI 1942278270
-
dba South Florida Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Hollywood, FL
- NPI 1942567839
-
dba New Port Richey Kidney Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Port Richey, FL
- NPI 1962470773
Locations
264 Southpark Cir E
St Augustine, FL 32086
Phone (904) 808-0445
Practitioners & affiliated clinicians
Affiliated clinicians 4
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": "1334102400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713398400000",
"number": "1962768242",
"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": "264 SOUTHPARK CIR E",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320865137",
"telephone_number": "904-808-0445",
"fax_number": "904-808-0446"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOTAL RENAL CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-04-11",
"last_updated": "2024-04-18",
"certification_date": "2024-04-18",
"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": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007297200",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "St. Augustine Dialysis",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "St. Augustine Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.