Delray Beach Dialysis Center LLC

Primary specialty

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

Legal business name

DELRAY BEACH DIALYSIS CENTER LLC

Practice address

5130 Linton Blvd
Suite G4
Delray Beach, FL 33484-6596

Phone

(561) 498-5959

Fax

(561) 498-5949

NPI assigned

Jul 4, 2006

Last updated

Mar 21, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jason Boucher

Title

Cfo

Phone

(978) 922-3080

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553126400000",
    "number": "1154351120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 LINTON BLVD",
            "address_2": "SUITE G-4",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846596",
            "telephone_number": "561-498-5959",
            "fax_number": "561-498-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 LINTON BLVD",
            "address_2": "SUITE G4",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846596",
            "telephone_number": "561-498-5959",
            "fax_number": "561-498-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELRAY BEACH DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2019-03-21",
        "status": "A",
        "authorized_official_last_name": "BOUCHER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "978-922-3080",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "892299300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delray Ambulatory Surgical & Laser Center
• Delray Anesthesia Services, LLC
• Delray Assisted Living LLC (The Cascades at Delray Senior Living)
• Delray Assisted Living LLC (Condor Senior Living)
• Delray Beach ASC, LLC (Delray Beach Surgery Center)
• Delray Beach Intensive Outpatient Program LLC
• Delray Beach Outpatient Services, LLC
• Delray Beach Surgical Suites, LLC
• Delray Beach Villa, LLC (Grand Villa of Delray Beach East)
• Delray Beach Wellness and Rehab

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Delray Beach, FL
• Providers in Delray 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 Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.