MISHAWAKA DIALYSIS
NPI 1376984443
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Mishawaka, IN

NPI Status: Active since July 17, 2013

Contact Information

1420 TRINITY PL
MISHAWAKA, IN
ZIP 46545
Phone: (574) 231-7204
Fax: (574) 231-7205

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  • Organization
  • Clinic/Center
  • End-Stage Renal Disease (ESRD) Treatment
  • Accepts Insurance

About MISHAWAKA DIALYSIS

This page provides the complete NPI Profile along with additional information for Mishawaka Dialysis, a provider established in Mishawaka, Indiana operating as a Clinic/center, focusing in end-stage renal disease (esrd) treatment . The healthcare provider is registered in the NPI registry with number 1376984443 assigned on July 2013. 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 Mishawaka Dialysis. The authorized official of this NPI record is Samuel T Wey (Vp Licensure & Certification)

NPI
1376984443
Provider Legal Name
ROUSHE DIALYSIS LLC
Other Organization Name
MISHAWAKA DIALYSIS
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1420 TRINITY PL MISHAWAKA, IN 46545
Location Phone
(574) 231-7204
Location Fax
(574) 231-7205
Mailing Address
5200 VIRGINIA WAY ATT: L&C DEPT BRENTWOOD, TN 37027
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-17-2013
Last Update Date
05-23-2024
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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 Care 24/7 - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - 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 Care 24/7 - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - 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 Care 24/7 - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + 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
  • Central Bronze - HMO
  • Central Bronze + Vision + Adult Dental - HMO
  • Central Gold - HMO
  • Central Gold + Vision + Adult Dental - HMO
  • Clear Silver - 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
  • Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
  • Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential 9200 (+ Incentives) - HMO
  • Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) - HMO
  • Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Essential 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Heart Healthy Bronze Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Heart Healthy Silver Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Essential 3500 HSA (+ Incentives) - HMO
  • Anthem Silver Essential 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Essential 7000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Essential 7000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - 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
  • Connect Bronze 3800 Indiv Med Deductible - EPO
  • Connect Bronze 7000 Indiv Med Deductible Enhanced Diabetes Care - EPO
  • Connect Bronze 8550 Indiv Med Deductible - EPO
  • Connect Bronze CMS Standard - EPO
  • Connect Gold CMS Standard - EPO
  • Connect Silver 3000 Indiv Med Deductible - EPO
  • Connect Silver 7000 Indiv Med Deductible - EPO
  • Connect Silver CMS Standard - EPO
  • MyPriority Balanced Silver - HMO
  • MyPriority Premier Silver - HMO
  • MyPriority Standard Bronze - HMO
  • MyPriority Standard Bronze - Travel - HMO
  • MyPriority Standard Gold - HMO
  • MyPriority Standard Silver - HMO
  • MyPriority Standard Silver - Travel - HMO
  • MyPriority Value Bronze - HMO
  • MyPriority Value Bronze HSA - 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 T 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
201228810AMEDICAID (05)IN 

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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.
1376984443
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
23146188848
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 4 + 6 + 1 + 8 + 8 + 8 + 4 + 8 + 24 = 77
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 77 = 33

The NPI number 1376984443 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1932451671TOTAL RENAL CARE INC
Organization
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)1420 TRINITY PL
MISHAWAKA, IN 46545
(574) 243-3764

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1376984443, enumerated in the NPI registry as an "organization" on July 17, 2013

The provider is located at 1420 Trinity Pl Mishawaka, In 46545 and the phone number is (574) 231-7204

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.

This NPI record was last updated on July 17, 2013. 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.