Pure Life Renal of Lansdowne, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

PURE LIFE RENAL OF LANSDOWNE, LLC

Practice address

19490 Sandridge Way
Suite 140
Leesburg, VA 20176-3465

Phone

(954) 962-5733

NPI assigned

Feb 28, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jeff Fernandez

Title

Cfo

Phone

(954) 962-5733

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Listed as

Pure Life Renal of Lansdowne Inc.CCN 492713

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Aug 28, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

16

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Oscar Adler, M.D., PHD

  • Nephrology Physician
  • Leesburg, VA
  • NPI 1700874138
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Oscar Adler, M.D., PHD

  • Nephrology Physician
  • Leesburg, VA
  • NPI 1700874138

  Dialysis facility

  Care Compare affiliation Name & address match
• Nusirat Adepeju Adebimpe Jinadu, MD

  • Nephrology Physician
  • Upper Marlboro, MD
  • NPI 1558518589

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1013457720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HOLLYWOOD BLVD",
            "address_2": "SUITE 300-N",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216751",
            "telephone_number": "216-264-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19490 SANDRIDGE WAY",
            "address_2": "SUITE 140",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763465",
            "telephone_number": "954-962-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE LIFE RENAL OF LANSDOWNE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "954-962-5733",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pulmonary and Critical Care Associates, P.C.
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• Stephanie Puloka, M.D.
• Aimee Punsalang, APRN
• Pure Pediatrics & Wellness LLC
• Hannah Purvis
• Andrea M Pyle, OTR-L
• Quality Medical Care Inc
• Reagan Wei Quan, M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Leesburg, VA
• Providers in Leesburg, VA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.