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MEDINA SQUARE DIALYSIS
NPI 1366961138
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Medina, OH

Active since September 13, 2017CLIA 36D2136134 · Waiver
4/5
Overall Rating
740 N COURT ST, MEDINA, OH 44256(330) 721-7824(330) 721-9540 Get Directions Write a Review

NPPES record last updated: August 21, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 21, 2024, Oct 10, 2022, May 26, 2021 and 1 more (4 updates tracked since 2017).

About Medina Square Dialysis NPPES

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

MEDINA SQUARE DIALYSIS (NPI 1366961138) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Medina, Ohio and active in the NPI registry since September 2017. The organization holds a CLIA Waiver certificate valid through September 4, 2027 and lists Samuel T Wey, Vp Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1366961138
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameICELANDIC DIALYSIS LLC
Location Address740 N COURT STMedina, OH 44256-1748
Mailing Address5200 Virginia Way, L&c DeptBrentwood, TN 37027-7569
Phone(330) 721-7824
Fax(330) 721-9540
Organization SubpartNo
Authorized OfficialSamuel T WeyVp Licensure & Certification · (615) 341-6641
Enumeration DateSeptember 13, 2017
Last NPPES UpdateAugust 21, 20244 updates tracked since enumeration
NPPES CertifiedAugust 21, 2024
✔ NPI 1366961138 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
740 N COURT ST, Medina, OH 44256
Open in Google Maps ↗

Other Names 1

Doing Business AsMedina Square Dialysis

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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 36D2136134

Medina Square Dialysis · Medina, OH
Active · expires Sep 4, 2027
CLIA Number36D2136134
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateSeptember 5, 2025
Certificate Expiration DateSeptember 4, 2027
Laboratory DirectorAkhilesh Rao
Laboratory Phone(330) 721-7824
Laboratory LocationMedina Square Dialysis740 N Court St, Medina, OH 44256
CLIA data matches this NPI record on: Address Name Phone
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 Medina Square Dialysis (CMS certification number 362873), from CMS Care Compare.

DaVita Medina Square Dialysis

Dialysis facility · Medina, OH
4/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainDaVita
CMS Certification Number362873
ESRD NetworkNetwork 9
Hemodialysis Stations8
Medicare-Certified SinceMarch 13, 2018
Location740 North Court StreetMedina, OH 44256 · Medina County
Phone(330) 721-7824
Services Offered
In-center hemodialysis

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 Icelandic Dialysis LLC's NPI number?

The NPI number for Icelandic Dialysis LLC is 1366961138. It was assigned to this organization in the NPPES registry on September 13, 2017. The provider is doing business as Medina Square Dialysis.

Where is Icelandic Dialysis LLC located?

Icelandic Dialysis LLC is located at 740 N Court St, Medina, OH 44256. The listed phone number is (330) 721-7824.

What is Icelandic 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 Icelandic Dialysis LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2136134) is associated with this NPI, valid through September 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Icelandic Dialysis LLC a Medicare-certified dialysis facility?

Yes. DaVita Medina Square Dialysis is a Medicare-certified dialysis facility, certified since March 13, 2018.

What quality rating does Icelandic Dialysis LLC have?

CMS rates DaVita Medina Square Dialysis 4 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

What insurance does Icelandic Dialysis LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 10 other insurers list Icelandic 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 Icelandic Dialysis LLC was last updated on August 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.