Universal Kidney Center of Pembroke Pines-Miramar LLC

Primary specialty

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

Legal business name

UNIVERSAL KIDNEY CENTER OF PEMBROKE PINES-MIRAMAR LLC

Practice address

18004 NW 6TH St Ste 101
Pembroke Pines, FL 33029-2823

Phone

(954) 433-9400

NPI assigned

Jul 23, 2006

Last updated

Feb 8, 2008By 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. Elmo Angelo V. Bartolome

Title

President

Phone

(954) 770-6540

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Universal Kidney Center of Pembroke Pines MiramarCCN 102841

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Jan 11, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

21

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

CLIA laboratory certificates

Locations

Affiliated clinicians 1

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

• Max F Benjamin, M.D

  • Specialist
  • Pembroke Pines, FL
  • NPI 1649369208

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1215959184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18004 NW 6TH ST STE 101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292823",
            "telephone_number": "954-433-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18004 NW 6TH ST STE 101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292823",
            "telephone_number": "954-433-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL KIDNEY CENTER OF PEMBROKE PINES-MIRAMAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "BARTOLOME",
        "authorized_official_first_name": "ELMO ANGELO",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-770-6540",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pembroke Pines, FL
• Providers in Pembroke Pines, 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 8, 2008; 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.