Crown Dialysis Center of Palm Beach LLC

Primary specialty

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

Legal business name

CROWN DIALYSIS CENTER OF PALM BEACH LLC

Practice address

4701 N Federal Hwy
Boca Raton, FL 33431-5135

Phone

(954) 993-5757

Fax

(954) 577-5776

NPI assigned

Aug 15, 2011

Last updated

Aug 19, 2011By 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

Bharat K Gupta, MDNPI 1114980075

Title

Member Manager

Phone

(954) 993-5757

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

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

• Florida Kidney and Hypertension Care PA

  • Nephrology Physician
  • Oakland Park, FL
  • NPI 1356306708

  O20061110000067

  Same enrollment

Listed as

Crown Dialysis Center of Palm Beach LLCCCN 682523

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Jul 24, 2012

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

8

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

CLIA laboratory certificates

Tax ID family

FL Kidney and Hypertens2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Florida Kidney and Hypertension Care PA

  • Nephrology Physician
  • Oakland Park, FL
  • NPI 1356306708
  NPD tax ID

Practitioners 3

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.

• Bharat Kumar Gupta, M.D., FACP

  • Nephrology Physician
  • Oakland Park, FL
  • NPI 1114980075
  NPD Authorized official
• Mark Ramos, NP

  • Adult Health Nurse Practitioner
  • Oakland Park, FL
  • NPI 1457895468
  NPD
• Kashif Abad, M.D.

  • Nephrology Physician
  • West Palm Beach, FL
  • NPI 1518405075
  NPD (past)

Affiliated clinicians 1

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

• Bharat Kumar Gupta, M.D., FACP

  • Nephrology Physician
  • Oakland Park, FL
  • NPI 1114980075

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1750660247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 N FEDERAL HWY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334315135",
            "telephone_number": "954-993-5757",
            "fax_number": "954-577-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 N FEDERAL HWY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334315135",
            "telephone_number": "954-993-5757",
            "fax_number": "954-577-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN DIALYSIS CENTER OF PALM BEACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-15",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "BHARAT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "954-993-5757",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxana Crosman, LMHC, NCC
• Cross Country Diagnostics
• Cross Country Staffing, Inc.
• Cross Countrymedicalsupplycoinc
• Philip Crouse
• John P Croyle Jr., PA-C
• David John Crutchley, PH.D.
• Yaniela Barbara Cruz Garcia
• Brittney Nicole Cruz
• Danielle Cruz, APRN

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Boca Raton, FL
• Providers in Boca Raton, 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 Aug 19, 2011; 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.