Yargol Dialysis LLC

Primary specialty

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

Legal business name

YARGOL DIALYSIS LLC

Doing business as

Winter Haven South Dialysis

Practice address

7220 Cypress Gardens Blvd
Winter Haven, FL 33884-3217

Phone

(863) 324-5040

Fax

(863) 324-8492

NPI assigned

Nov 2, 2013

Organization subpart

No

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

Authorized official

Name

Samuel T. Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Winter Haven South Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

DaVita Winter Haven South DialysisCCN 682552

Overall star rating

1.0 of 5

Ownership

Profit

Certified

May 7, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

12

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

Networks

• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Affiliated clinicians 3

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

• Haldane W Porteous, M.D

  • Nephrology Physician
  • Winter Haven, FL
  • NPI 1134358716

  Dialysis facility

  Care Compare affiliation Name & address match
• Ricardo Vilches, MD

  • Nephrology Physician
  • Lakeland, FL
  • NPI 1699840454

  Dialysis facility

  Care Compare affiliation Name & address match
• Amapola Dumlao Whiteside, MD

  • Nephrology Physician
  • Lake City, FL
  • NPI 1760657688

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1104255983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4593",
            "fax_number": "800-293-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 CYPRESS GARDENS BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843217",
            "telephone_number": "863-324-5040",
            "fax_number": "863-324-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YARGOL DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012387900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winter Haven South Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Winter Haven South Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rudolf George Wunsch Jr., DMD
• Lois M Wygonik, CRNA
• Elizabeth Xavier, O.D.
• Mary Yakovets
• Hui Yang, OTR/L
• Yeritza Jaquez DDS PLLC
• Jae Yeon You, DDS
• Lewayne A Young, COTA
• Nakesha Young
• Allison Youngberg, COTA/L

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Winter Haven, FL
• Providers in Winter Haven, 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 Feb 5, 2024; 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.