Clewiston Dialysis Center LLC

Primary specialty

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

Legal business name

CLEWISTON DIALYSIS CENTER LLC

Practice address

851 W Ventura Ave
Clewiston, FL 33440-3409

Phone

(863) 983-8855

Fax

(863) 983-5216

NPI assigned

Dec 9, 2014

Organization subpart

No

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

Authorized official

Name

Sara Anne Brady

Title

Chief Nursing Officer

Phone

(208) 371-7878

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Clewiston Dialysis CenterCCN 102741

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Oct 21, 1998

Medicare certification status

ActiveFrom the Provider of Services file

Chain

American Renal Associates

Dialysis stations

10

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

CLIA laboratory certificates

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 2

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

• Manoj Bhattarai, MD

  • Nephrology Physician
  • Royal Palm Beach, FL
  • NPI 1881905925

  Dialysis facility

  Care Compare affiliation Name & address match
• Fernando Enrique Ottino, M.D.

  • Nephrology Physician
  • Loxahatchee, FL
  • NPI 1326224569

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1144628017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 W VENTURA AVE",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403409",
            "telephone_number": "863-983-8855",
            "fax_number": "863-983-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 W VENTURA AVE",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403409",
            "telephone_number": "863-983-8855",
            "fax_number": "863-983-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEWISTON DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-09",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CHIEF NURSING OFFICER",
        "authorized_official_telephone_number": "208-371-7878"
    },
    "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": "014649900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diosmary Cardentey, LMHC
• Ramon Leonard Carroll Jr., M.D.
• Sarahy M Cervera
• Thania Chavez Olvera
• Ximena Checa, DMD
• Clewiston Nursing & Rehabilitation, LLC
• Clewiston Nursing and Rehab Opco LLC
• Clewiston SNF Operations LLC
• Lisandra Concepcion Aponte
• Susan Conley, FNP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Clewiston, FL
• Providers in Clewiston, 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 May 19, 2026; 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.