New Life Dialysis Center Inc

Primary specialty

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

Legal business name

NEW LIFE DIALYSIS CENTER INC

Practice address

2720 SW 97TH Ave Suite 201
Miami, FL 33165-2680

Phone

(786) 963-9155

Fax

(786) 963-9181

NPI assigned

May 17, 2024

Organization subpart

No

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

Authorized official

Name

Devorath FonsecaNPI 1447009741

Title

President

Phone

(786) 963-9155

Specialties & licenses 1

Addresses

Other names 1

• New Life Dialysis Center INC Former legal business name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

New Life Dialysis Center Inc.CCN 682795

Ownership

Profit

Certified

Dec 17, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

15

Practitioners 1

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

• Devorath Fonseca

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Miami, FL
  • NPI 1447009741
  NPD Authorized official

Affiliated clinicians 1

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

• Juan A Fernandez, MD

  • Nephrology Physician
  • Miami, FL
  • NPI 1568481620

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1396594602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 SW 97TH AVE SUITE 201",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331652680",
            "telephone_number": "786-963-9155",
            "fax_number": "786-963-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 SW 97TH AVE SUITE 201",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331652680",
            "telephone_number": "786-963-9155",
            "fax_number": "786-963-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE DIALYSIS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "FONSECA",
        "authorized_official_first_name": "DEVORATH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-963-9155"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Life Dialysis Center INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Miami, FL
• Providers in Miami, 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 Jun 3, 2024; 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.