MALLORY PARK DIALYSIS
NPI 1336682707
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Dayton, OH


Overall Rating: 1 out of 5 stars

NPI Status: Active since December 02, 2016

Contact Information

2808 GERMANTOWN ST
DAYTON, OH
ZIP 45417
Phone: (937) 262-8427
Fax: (937) 262-8016

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  • Organization
  • Clinic/Center
  • End-Stage Renal Disease (ESRD) Treatment
  • Accepts Insurance
  • CLIA Number: 36D2126024
  • CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
  • CLIA Exp. Date: 02-16-2027

About MALLORY PARK DIALYSIS

This page provides the complete NPI Profile along with additional information for Mallory Park Dialysis, a provider established in Dayton, Ohio operating as a Clinic/center, focusing in end-stage renal disease (esrd) treatment . The healthcare provider is registered in the NPI registry with number 1336682707 assigned on December 2016. The practitioner's primary taxonomy code is 261QE0700X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Mallory Park Dialysis. The authorized official of this NPI record is Samuel Wey (Vp Licensure & Certification)

NPI
1336682707
Provider Legal Name
ISD RENAL INC
Other Organization Name
MALLORY PARK DIALYSIS
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2808 GERMANTOWN ST DAYTON, OH 45417
Location Phone
(937) 262-8427
Location Fax
(937) 262-8016
Mailing Address
5200 VIRGINIA WAY ATT: L&C DEPT BRENTWOOD, TN 37027
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-02-2016
Last Update Date
06-06-2024
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According to the Dialysis Facility Compare program data, Mallory Park Dialysis has a much below average overall quality rating based on the patient's quality of care based on data that dialysis centers report to Medicare. The Quality of Patient Star Rating for this facility is 1 out of 5 stars.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center End-Stage Renal Disease (ESRD) Treatment

Taxonomy Code
261QE0700X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision - HMO
  • Clear Silver - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Anthem Bronze Pathway HMO 7450 for HSA - HMO
  • Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Catastrophic Pathway HMO 9200 - HMO
  • Anthem Gold Pathway HMO 1500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Bronze Pathway HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Silver Pathway X HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway HMO 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway HMO 5000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway HMO 5400 for HSA - HMO
  • Anthem Silver Pathway X HMO 4000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Bronze First 7500 $25 Generic Drugs - HMO
  • Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Gold 1500 $15 Generic Drugs - HMO
  • Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Select Drugs - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • HSA Eligible Bronze 6000 - HMO
  • Low Deductible Silver 4500 $3 Generic Drugs - HMO
  • Low Deductible Silver 4500 $3 Generic Drugs Adult Vision & Fitness - HMO
  • Low Premium Bronze 9200 $25 Generic Drugs - HMO
  • Low Premium Bronze 9200 $25 Generic Drugs Adult Vision & Fitness - HMO
  • MHP Bronze - HMO
  • MHP Bronze Saver (Expanded) - HMO
  • MHP Expanded Bronze Standard - HMO
  • MHP Gold - HMO
  • MHP Gold Standard - HMO
  • MHP Silver Exchange - HMO
  • MHP Silver Exchange Rewards - HMO
  • MHP Silver Standard - HMO
  • MHP Young Adult/Catastrophic - HMO
  • Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
  • Bronze HSA $7,300 ON-EX - HMO
  • Bronze Standard w/ Virtual & Wellness - HMO
  • Gold $1250 w/ Virtual & Wellness ON-EX - HMO
  • Gold $500 w/ Virtual & Wellness ON-EX - HMO
  • Gold Standard w/ Virtual & Wellness - HMO
  • Silver $5000 w/ Virtual & Wellness ON-EX - HMO
  • Silver Standard w/ Virtual & Wellness - HMO
  • SilverSelect w/ Virtual & Wellness ON-EX - HMO
  • Young Adult Essentials ON-EX - HMO
  • SummaCare Bronze 8000 - HMO
  • SummaCare Bronze 8000 with Adult Vision Exam - HMO
  • SummaCare Bronze 9200 with 3 Free PCP Visits - HMO
  • SummaCare Bronze 9200 with 3 Free PCP Visits + Adult Vision - HMO
  • SummaCare Gold 2000 with 3 Free PCP Visits - HMO
  • SummaCare Gold 2000 with 3 Free PCP Visits + Adult Vision - HMO
  • SummaCare Silver 3500 with 3 Free PCP Visits + Adult Vision - HMO
  • SummaCare Silver 5000 1000 Rx with 3 Free PCP Visits - HMO
  • SummaCare Silver 6000 with 3 Free PCP Visits + Adult Vision Exam - HMO
  • SummaCare Silver 7000 with 3 Free PCP Visits - HMO
  • SummaCare Standard Bronze - HMO
  • SummaCare Standard Bronze with Adult Vision - HMO
  • SummaCare Standard Gold - HMO
  • SummaCare Standard Gold with Adult Vision - HMO
  • SummaCare Standard Silver - HMO
  • SummaCare Standard Silver with Adult Vision - HMO
  • SummaCare Value with 3 Free PCP Visits + Adult Vision - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
  • UHC Bronze Value ($5 Tier 2 Rx, No Referrals) - HMO
  • UHC Bronze Value+ ($5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Advantage ($3 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Gold Standard+ (Dental + Vision, No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Silver Standard (No Referrals) - HMO
  • UHC Silver Standard+ (Dental + Vision, No Referrals) - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SAMUEL WEY

Authorized Official Title
VP LICENSURE & CERTIFICATION
Authorized Official Phone
(615) 341-6641

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
0253536MEDICAID (05)OH 

Dialysis Facility Compare Information

Quality of Patient Care Rating Quality of Patient Care Rating
The Medicare program calculates star ratings using specific measure data reported by dialysis centers to Medicare and data from the In-Center Hemodialysis CAHPS Survey.
- 1 out of 5 stars - A Much Below Average
Dialysis Facility TypeProfit
Is it part of a chain?Yes
Corporate NameDaVita
Shifts Starting After 5PM Shifts Starting After 5PM
If you can start your dialysis treatment at 5pm or later. These centers may also offer the ability for you to receive dialysis while you sleep.
No
In-Center Hemodialysis In-Center Hemodialysis
Hemodialysis is the most common method for treating advanced and permanent kidney failure. In hemodialysis, your blood flows slowly through a filter to remove wastes and extra fluids and the clean blood is returned to your body.
Yes
Number of Hemodialysis Stations Number of Hemodialysis Stations
The number of hemodialysis stations in the dialysis facility.
24
Peritoneal Dialysis Peritoneal Dialysis
Peritoneal dialysis is a treatment for kidney failure that uses the lining of your abdomen, or belly, to filter your blood inside your body. It uses a soft tube to fill your abdomen with a cleansing liquid that removes waste products from your body and the liquid is drained out of your body after a few hours.
No
Home Hemodialysis Training Home Hemodialysis Training
If the dialysis center offers training for patients and caregivers to learn to do hemodialysis treatments at home.
No
Certification or Recertification Date10-12-2017

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
36D2126024
Facility Type
End Stage Renal Disease Dialysis Facility
Certificate Effective Date
February 17, 2025
Certificate Expiration Date
February 16, 2027
Laboratory Director
SAMPATH THIRUVEEDI
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Mallory Park Dialysis to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for MALLORY PARK DIALYSIS

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1336682707
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2366128470
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 6 + 6 + 1 + 2 + 8 + 4 + 7 + 0 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 77

The NPI number 1336682707 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1336682707, enumerated in the NPI registry as an "organization" on December 02, 2016

The provider is located at 2808 Germantown St Dayton, Oh 45417 and the phone number is (937) 262-8427

This medical organization specializes in Clinic/Center with taxonomy code 261QE0700X with a focus in End-Stage Renal Disease (ESRD) Treatment

The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Meridian, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 36D2126024 for a "end stage renal disease dialysis facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

The Overall Quality Rating of this dialysis facility is 1 out of 5 stars which is a much below average when compared to similar facilities. The overall quality rating is calculated using specific measure data reported by dialysis centers to Medicare and data from the In-Center Hemodialysis CAHPS Survey.

This NPI record was last updated on December 02, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.