MUKWONAGO DIALYSIS CENTER
NPI 1578649109
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Mukwonago, WI

NPI Status: Active since October 27, 2006

Contact Information

400 BAY VIEW RD STE F
MUKWONAGO, WI
ZIP 53149
Phone: (262) 363-1925
Fax: (262) 363-1928

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  • Organization
  • Clinic/Center
  • End-Stage Renal Disease (ESRD) Treatment
  • CLIA Number: 52D0988765
  • CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
  • CLIA Exp. Date: 07-08-2027

About MUKWONAGO DIALYSIS CENTER

This page provides the complete NPI Profile along with additional information for Mukwonago Dialysis Center, a provider established in Mukwonago, Wisconsin operating as a Clinic/center, focusing in end-stage renal disease (esrd) treatment . The healthcare provider is registered in the NPI registry with number 1578649109 assigned on October 2006. The practitioner's primary taxonomy code is 261QE0700X. The provider is registered as an organization and their NPI record was last updated 16 years ago. The provider's is doing business as Mukwonago Dialysis Center. The authorized official of this NPI record is Ms. Tina M Waldron (Billing Supervisor)

NPI
1578649109
Provider Legal Name
PURITY DIALYSIS CENTERS, INC
Other Organization Name
MUKWONAGO DIALYSIS CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
400 BAY VIEW RD STE F MUKWONAGO, WI 53149
Location Phone
(262) 363-1925
Location Fax
(262) 363-1928
Mailing Address
2301 SUN VALLEY DR STE 200 DELAFIELD, WI 53018
Mailing Phone
(262) 646-4162
Mailing Fax
(262) 363-1928
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-27-2006
Last Update Date
05-13-2010
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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
License State
WI

Insurance Plans Accepted

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

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

MS. TINA M WALDRON

Authorized Official Title
BILLING SUPERVISOR
Authorized Official Phone
(262) 646-6426

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
52D0988765OTHER (01)WIMDC CLIA #
522521MEDICARE PIN (08)WI 
42053800MEDICAID (05)WI 

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
52D0988765
Facility Type
End Stage Renal Disease Dialysis Facility
Certificate Effective Date
July 09, 2025
Certificate Expiration Date
July 08, 2027
Laboratory Director
IMRAN SAJJAD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Mukwonago Dialysis Center 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.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1578649109, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
8
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
4
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
1
Unchanged
Pos 9
0
Doubled → 0
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 6 → 12 → 3 9 → 18 → 9 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 4 + 8 + 1 + 2 + 4 + 1 + 8 + 1 + 0 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1578649109.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
400 BAY VIEW RD STE F
MUKWONAGO, WI 53149

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1578649109, enumerated as an "organization" on October 27, 2006.

The provider is located at 400 BAY VIEW RD STE F MUKWONAGO, WI 53149 and the phone number is (262) 363-1925.

Clinic/Center with taxonomy code 261QE0700X and a focus in End-Stage Renal Disease (ESRD) Treatment.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.