Active NPI
Tri-Cities Dialysis LLC
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Geneva, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- TRI-CITIES DIALYSIS LLC
- Practice address
- 306 Randall Rd
Geneva, IL 60134-4200 - Phone
- (630) 262-1306
- NPI assigned
- May 23, 2005
- 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
- Mr. Calvin Ganong
- Title
- Chief Operating Officer
- Phone
- (630) 851-1206
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
306 Randall Rd
Geneva, IL 60134-4200
Mailing address
1300 Waterford Dr
Lowr Level
Aurora, IL 60504-5502
Phone (630) 851-1206
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50019 | Other | IL | BLUE CROSS NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100625000813 | IL | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 2264563881 | Practice locations: Geneva, IL |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- Tri Cities Dialysis LLC
- Overall star rating
- Ownership
- Profit
- Certified
- Mar 5, 2001
- Medicare certification status
- Active
- Dialysis stations
- 20
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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0986878 | Tri Cities Dialysis | Certificate of waiver | May 22, 2027 |
National Provider Directory
National Provider DirectoryLocations
306 Randall Rd
Geneva, IL 60134
Phone (630) 262-1306
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Batavia, IL
- NPI 1649228727
-
- Nephrology Physician
- Aurora, IL
- NPI 1720046618
-
- Nephrology Physician
- Aurora, IL
- NPI 1205870276
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": "1116806400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213833600000",
"number": "1982607156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 WATERFORD DR",
"address_2": "LOWR LEVEL",
"city": "AURORA",
"state": "IL",
"postal_code": "605045502",
"telephone_number": "630-851-1206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 RANDALL RD",
"city": "GENEVA",
"state": "IL",
"postal_code": "601344200",
"telephone_number": "630-262-1306"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRI-CITIES DIALYSIS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-05-23",
"last_updated": "2008-06-19",
"status": "A",
"authorized_official_last_name": "GANONG",
"authorized_official_first_name": "CALVIN",
"authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
"authorized_official_telephone_number": "630-851-1206",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS NUMBER",
"identifier": "50019",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Geneva, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.