Organization Active NPI

360 Kidney Care

  • Nephrology Physician
  • Brownsville, TX
National Provider Identifier
1104427970
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
360 KIDNEY CARE
Practice address
4970 N Expressway Ste D
Brownsville, TX 78526-4269
Phone
(956) 897-0304
Fax
(888) 313-1449
NPI assigned
Nov 6, 2020
Last updated
Nov 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Authorized official

Name
Dr. Paul-Moreau Bossous, MDNPI 1487975439
Title
President
Phone
(956) 897-0304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

4970 N Expressway Ste D
Brownsville, TX 78526-4269

Mailing address

4970 N Expressway Ste D
Brownsville, TX 78526-4269
Phone (956) 897-0304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201123002851 TX Part B Supplier - Clinic/Group Practice 6507277589 Receives reassigned benefits from 1 practitioner
Practice locations: Brownsville, TX

National Provider Directory

National Provider Directory

Locations

4970 N Expressway
Ste D
Brownsville, TX 78526
Phone (956) 350-2050

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1104427970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4970 N EXPRESSWAY STE D",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785264269",
            "telephone_number": "956-897-0304",
            "fax_number": "888-313-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4970 N EXPRESSWAY STE D",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785264269",
            "telephone_number": "956-897-0304",
            "fax_number": "888-313-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 KIDNEY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "BOSSOUS",
        "authorized_official_first_name": "PAUL-MOREAU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-897-0304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.