Kidney Care of Bonita Springs LLC

Primary specialty

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

Legal business name

KIDNEY CARE OF BONITA SPRINGS LLC

Practice address

26381 S Tamiami TRL Ste 122
Bonita Springs, FL 34134-7803

Phone

(239) 388-7770

Fax

(239) 319-5826

NPI assigned

Feb 7, 2023

Organization subpart

No

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

Authorized official

Name

Federico Dumenigo

Title

Chief Executive Officer

Phone

(305) 448-6261

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Kidney Care of Bonita Springs, LLCCCN 682769

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Jun 14, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

12

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 2

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

• Ankush Gulati, M.D

  • Nephrology Physician
  • Lehigh Acres, FL
  • NPI 1265445654

  Dialysis facility

  Care Compare affiliation Name & address match
• Nijal Sheth

  • Nephrology Physician
  • Naples, FL
  • NPI 1740422187

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1548966930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 SW 72ND AVE STE 208",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331555549",
            "telephone_number": "305-448-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26381 S TAMIAMI TRL STE 122",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341347803",
            "telephone_number": "239-388-7770",
            "fax_number": "239-319-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CARE OF BONITA SPRINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "DUMENIGO",
        "authorized_official_first_name": "FEDERICO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "305-448-6261"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laura Khawaja, PA
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• Kidz Medical Services
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• Kinexis LLC
• Kinexis LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bonita Springs, FL
• Providers in Bonita Springs, 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 7, 2023; 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.