Kidneyspa at Bird Road, LLC

Primary specialty

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

Legal business name

KIDNEYSPA AT BIRD ROAD, LLC

Practice address

11501 SW 40TH St Ste 101
Miami, FL 33165-3313

Phone

(305) 329-2900

NPI assigned

Sep 15, 2022

Organization subpart

No

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

Authorized official

Name

Juan Mauricio Cuellar, MDNPI 1285617621

Title

Ceo

Phone

(305) 329-2900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

KidneySPA at Bird RoadCCN 682757

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 28, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

11

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

CLIA laboratory certificates

Practitioners 1

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

• Juan M Cuellar, MD

  • Nephrology Physician
  • Miami, FL
  • NPI 1285617621
  NPD (past) Authorized official

Affiliated clinicians 1

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

• Juan M Cuellar, MD

  • Nephrology Physician
  • Miami, FL
  • NPI 1285617621

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698364800000",
    "number": "1770205759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 NW 12TH AVE APT 508",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331282206",
            "telephone_number": "305-329-2900",
            "fax_number": "305-329-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11501 SW 40TH ST STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653313",
            "telephone_number": "305-329-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEYSPA AT BIRD ROAD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A",
        "authorized_official_last_name": "CUELLAR",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "MAURICIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-329-2900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidney MD LLC
• Kidney Partners Coral Gables LLC
• Kidney Spa LLC
• Kidney Specialty Center Inc.
• Kidney Treatment and Hypertension Associates PA
• Kids Advante Mental Corp
• Kids Behaviors
• Kids Behaviors LLC
• Kids Cardiac Center PA
• Kids Chat Therapy

• 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 Oct 27, 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.