Kidney Doctors Dialysis Center Inc

Primary specialty

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

Legal business name

KIDNEY DOCTORS DIALYSIS CENTER INC

Practice address

12145 Pembroke Rd
Pembroke Pines, FL 33025-1727

Phone

(954) 743-5804

Fax

(954) 743-4747

NPI assigned

Aug 10, 2018

Last updated

May 26, 2022By 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. Francisco Jose Bernal Perez, ARNP, FNP-CNPI 1083165369

Title

Director/Administrator/Don

Phone

(786) 365-6624

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL3 enrollments

Enrollment records 3

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Kidney Doctors Dialysis Center Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Miami Gardens, FL
  • NPI 1033838230

  5395098131

  Same PAC ID
• Kidney Doctors Dialysis Center Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Miami Lakes, FL
  • NPI 1568153500

  5395098131

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Kidney Doctors Dialysis Center Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Miami Gardens, FL
  • NPI 1033838230

  O20220531002608

  Same enrollment
• Kidney Doctors Dialysis Center Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Miami Lakes, FL
  • NPI 1568153500

  O20230217000251

  Same enrollment

Listed as

Kidney Doctor's Dialysis CenterCCN 682668

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Feb 14, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

24

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

• HealthSun Health Plans Network

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Francisco J Bernal Perez, DNP

  • Family Nurse Practitioner
  • Pembroke Pines, FL
  • NPI 1083165369
  Authorized official Same address or phone

Affiliated clinicians 1

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

• Pedro Hernandez-Lopez, M.D.

  • Nephrology Physician
  • Pembroke Pines, FL
  • NPI 1649498569

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1538648407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12145 PEMBROKE RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330251727",
            "telephone_number": "954-743-5804",
            "fax_number": "954-743-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12145 PEMBROKE RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330251727",
            "telephone_number": "954-743-5804",
            "fax_number": "954-743-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY DOCTORS DIALYSIS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-10",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "BERNAL PEREZ",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "DIRECTOR/ADMINISTRATOR/DON",
        "authorized_official_telephone_number": "786-365-6624",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ARNP, FNP-C"
    },
    "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": "102376800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eileen Kiang, DO
• Kid Safety Hats,LLC (Opti-Cool Headgear)
• Amarrie Oneida Kidd
• Randall Kidd
• Kidney Care Plus Inc
• Kids Miracle Steps, Inc.
• Kidz Development Lab Corp
• David Kim, BCBA
• Yolanda Kimble, APRN, AGPCNP-BC
• Jeffrey Kimm, M.D.

• 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 May 26, 2022; 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.