FOND DU LAC DIALYSIS CENTER
NPI 1619955838
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Fond Du Lac, WI
Overall Rating: 2 out of 5 stars
NPI Status: Active since January 06, 2006
Contact Information
101 S PIONEER RD
FOND DU LAC, WI
ZIP 54935
Phone: (920) 923-2333
Fax: (920) 926-8885
- Organization
- Clinic/Center
- End-Stage Renal Disease (ESRD) Treatment
- Accepts Insurance
- CLIA Number: 52D0997010
- CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
- CLIA Exp. Date: 03-03-2028
About FOND DU LAC DIALYSIS CENTER
This page provides the complete NPI Profile along with additional information for Fond Du Lac Dialysis Center, a provider established in Fond Du Lac, 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 1619955838 assigned on January 2006. The practitioner's primary taxonomy code is 261QE0700X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Fond Du Lac Dialysis Center. The authorized official of this NPI record is Steven N Little (Svp & Cfo)
- NPI
- 1619955838
- Provider Legal Name
- WAUPUN MEMORIAL HOSPITAL
- Other Organization Name
- FOND DU LAC DIALYSIS CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 101 S PIONEER RD FOND DU LAC, WI 54935
- Location Phone
- (920) 923-2333
- Location Fax
- (920) 926-8885
- Mailing Address
- PO BOX 1283 FOND DU LAC, WI 54936
- Mailing Phone
- (920) 926-4472
- Mailing Fax
- (920) 926-8885
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-06-2006
- Last Update Date
- 03-12-2022
- Code Navigator
According to the Dialysis Facility Compare program data, Fond Du Lac Dialysis Center has a 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 2 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:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Prestige Bronze $0 Medical Deductible - HMO
- Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
- Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
- Prestige Bronze Essential + 3 Free PCP Visits - HMO
- Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Bronze Plus - HMO
- Prestige Gold - HMO
- Prestige Gold 50 + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO
- Prestige Gold Essential + 3Free PCP Visits - HMO
- Prestige Gold Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Silver - HMO
- Prestige Silver Essential + 3 Free PCP Visits - HMO
- Prestige Silver Essential + Dental + Vision + 3 Free PCP Visits - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $700 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE (DENTAL & VISION) $700 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $8,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $9,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $8,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $9,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER STANDARD EASY PRICING - HMO
- QUARTZ ONE ACHIEVE W/GUNDERSEN BRONZE $0 MEDICAL DED - 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.
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 |
|---|---|---|---|
| 42052300 | MEDICAID (05) | WI | |
| 42052300 | OTHER (01) | WI | WI CHRONIC DISEASE PROGRA |
| Z3 | OTHER (01) | WI | DEAN CARE |
Dialysis Facility Compare Information
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
- 52D0997010
- Facility Type
- End Stage Renal Disease Dialysis Facility
- Certificate Effective Date
- March 04, 2026
- Certificate Expiration Date
- March 03, 2028
- Laboratory Director
- DR. RAFAL CIECIERSKI
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fond Du Lac 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.
Reviews for FOND DU LAC DIALYSIS CENTER
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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 1619955838, we treat the final digit (8) 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 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 72 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619955838, enumerated as an "organization" on January 06, 2006.
The provider is located at 101 S PIONEER RD FOND DU LAC, WI 54935 and the phone number is (920) 923-2333.
Clinic/Center with taxonomy code 261QE0700X and a focus in End-Stage Renal Disease (ESRD) Treatment.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Network Health,. Please consult your insurance carrier or call the provider to verify.
