NPIMap

Organization Active NPI

My Kidney Care, LLC

  • Nephrology Physician
  • Farmington, NM
National Provider Identifier
1235611484
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
MY KIDNEY CARE, LLC
Practice address
301 S Lake St Ste B
Farmington, NM 87401-5603
Phone
(505) 278-8575
NPI assigned
Sep 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Authorized official

Name
Manish Pandya, MDNPI 1326145392
Title
Owner
Phone
(505) 716-7887

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

301 S Lake St Ste B
Farmington, NM 87401-5603

Mailing address

301 S Lake St Ste B
Farmington, NM 87401-5603
Phone (505) 278-8575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181016003212 NM Part B Supplier - Clinic/Group Practice 4587916747 Receives reassigned benefits from 5 practitioners
Practice locations: Farmington, NM
O20231101003253 AZ Part B Supplier - Clinic/Group Practice 4587916747 Receives reassigned benefits from 1 practitioner
Practice locations: Page, AZ

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2153798My Kidney Care LLC301 S Lake St Suite B, Farmington, NM 87401Provider-performed microscopyAug 29, 2026

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0cf77109-e68f-4848-a530-1f53e0c2db32/

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1235611484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S LAKE ST STE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015603",
            "telephone_number": "505-278-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S LAKE ST STE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015603",
            "telephone_number": "505-278-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY KIDNEY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A",
        "authorized_official_last_name": "PANDYA",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-716-7887",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.