Ponca Dialysis LLC
NPI 1538400239 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · San Jose, CA
Enrolled with Medicare as Part a Provider - End-Stage Renal Disease Facility (esrd) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ponca Dialysis LLC is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center organization in San Jose, CA (NPI 1538400239).
Provider details
- NPI number
- 1538400239
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Samuel Wey, Vp Licensure & Certification(615) 341-6641
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Tully Road Home Training
- Doing business as
- Tully Road Home Training
Registry dates
- Enumerated
- 2013-03-06
- Last updated
- 2024-03-29
- Certified
- 2024-03-29
Frequently asked questions
- What is Ponca Dialysis LLC's NPI number?
- Ponca Dialysis LLC's National Provider Identifier (NPI) is 1538400239, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ponca Dialysis LLC?
- Ponca Dialysis LLC is classified in the NPPES registry as End-Stage Renal Disease (ESRD) Treatment Clinic/Center (Ambulatory Health Care Facilities).
- Where is Ponca Dialysis LLC located?
- Ponca Dialysis LLC's practice location on file with NPPES is 1290 Tully Rd, San Jose, CA 95122-3069.
- What is Ponca Dialysis LLC's phone number?
- The practice phone number listed in the NPPES registry for Ponca Dialysis LLC is (408) 275-0105.
- Does Ponca Dialysis LLC accept Medicare?
- Ponca Dialysis LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Ponca Dialysis LLC?
- The authorized official listed on Ponca Dialysis LLC's NPPES record is Samuel Wey, Vp Licensure & Certification. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ponca Dialysis LLC's NPI active?
- Yes — Ponca Dialysis LLC's NPI (1538400239) is active in the NPPES registry as of the last update on 2024-03-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.