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MAPLE GROVE DIALYSIS LLC
NPI 1255518247
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Maple Grove, MN

Active since January 22, 2008CLIA 24D1080417 · Waiver
3/5
Overall Rating
15655 GROVE CIR N, MAPLE GROVE, MN 55369(763) 420-2804(763) 420-7162 Get Directions Write a Review

NPPES record last updated: April 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 11, 2025, Feb 15, 2023, Nov 12, 2020 and 3 more (6 updates tracked since 2017).

About Maple Grove Dialysis Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAPLE GROVE DIALYSIS LLC (NPI 1255518247), doing business as Maple Grove Dialysis Unit, is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Maple Grove, Minnesota and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through February 21, 2028 and lists Samuel T Wey, Vp Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1255518247
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameMAPLE GROVE DIALYSIS LLC
Location Address15655 GROVE CIR NMaple Grove, MN 55369-4489
Mailing Address5200 Virginia Way, L&c DeptBrentwood, TN 37027-7569
Phone(763) 420-2804
Fax(763) 420-7162
Organization SubpartNo
Authorized OfficialSamuel T WeyVp Licensure & Certification · (615) 341-6641
Enumeration DateJanuary 22, 2008
Last NPPES UpdateApril 11, 20256 updates tracked since enumeration
NPPES CertifiedApril 11, 2025
✔ NPI 1255518247 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
15655 GROVE CIR N, Maple Grove, MN 55369
Open in Google Maps ↗

Other Names 1

Doing Business AsMaple Grove Dialysis Unit

Other Identifiers 1

Medicaid1255518247MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica, UnitedHealthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D1080417

Maple Grove Dialysis Unit · Maple Grove, MN
Active · expires Feb 21, 2028
CLIA Number24D1080417
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateFebruary 22, 2026
Certificate Expiration DateFebruary 21, 2028
Laboratory DirectorMary Tahnk Johnson
Laboratory Phone(615) 341-6793
Laboratory LocationMaple Grove Dialysis Unit15655 Grove Circle North, Maple Grove, MN 55369
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for DaVita Maple Grove Dialysis Unit (CMS certification number 242571), from CMS Care Compare.

DaVita Maple Grove Dialysis Unit

Dialysis facility · Maple Grove, MN
3/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainDaVita
CMS Certification Number242571
ESRD NetworkNetwork 11
Hemodialysis Stations12
Medicare-Certified SinceJuly 3, 2008
Location15655 GROVE CIR NMaple Grove, MN 55369 · Hennepin County
Phone(763) 420-2804
Services Offered
In-center hemodialysis Peritoneal dialysis Home hemodialysis training

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maple Grove Dialysis LLC's NPI number?

The NPI number for Maple Grove Dialysis LLC is 1255518247. It was assigned to this organization in the NPPES registry on January 22, 2008. The provider is doing business as Maple Grove Dialysis Unit.

Where is Maple Grove Dialysis LLC located?

Maple Grove Dialysis LLC is located at 15655 Grove Cir N, Maple Grove, MN 55369. The listed phone number is (763) 420-2804.

What is Maple Grove Dialysis LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Maple Grove Dialysis LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D1080417) is associated with this NPI, valid through February 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Maple Grove Dialysis LLC a Medicare-certified dialysis facility?

Yes. DaVita Maple Grove Dialysis Unit is a Medicare-certified dialysis facility, certified since July 3, 2008.

What quality rating does Maple Grove Dialysis LLC have?

CMS rates DaVita Maple Grove Dialysis Unit 3 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

What insurance does Maple Grove Dialysis LLC accept?

Health plans from HealthPartners, Medica and UnitedHealthcare list Maple Grove Dialysis LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Maple Grove Dialysis LLC was last updated on April 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.