Pure Life Renal of West Palm Beach, LLC

Primary specialty

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

Legal business name

PURE LIFE RENAL OF WEST PALM BEACH, LLC

Practice address

1522 N Dixie Hwy
West Palm Beach, FL 33401-2720

Phone

(954) 962-5733

NPI assigned

Oct 4, 2018

Organization subpart

No

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

Authorized official

Name

Jeff Fernandez

Title

Chief Financial Officer

Phone

(954) 962-5733

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Pure Life Renal of West Palm Beach, LLCCCN 102777

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Mar 20, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Other

Dialysis stations

19

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

CLIA laboratory certificates

Affiliated clinicians 1

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

• Sergio R Vega, M.D.

  • Nephrology Physician
  • West Palm Beach, FL
  • NPI 1336146679

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1013482215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HOLLYWOOD BLVD STE 300N",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211242",
            "telephone_number": "954-962-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 N DIXIE HWY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012720",
            "telephone_number": "954-962-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE LIFE RENAL OF WEST PALM BEACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "954-962-5733"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dayami Pupo
• Lauren Marie Purcell, MOT-OTR/L
• Moss Hannon Purcell
• Pure Arrogancy Prosthesis Supplies
• Pure Dental Care,P.a.
• Christopher Pureza
• Sandra Puron, RBT
• Alisiann L Purrier, DNP FNP-C
• Laurie A Purvis, LCSW
• Puzzle Behavior Services Corp

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.