NPIMap

Organization Active NPI

Central Florida Kidney Centers Inc

Doing business as Palm Bay Kidney Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Palm Bay, FL
National Provider Identifier
1952307589
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
CENTRAL FLORIDA KIDNEY CENTERS INC
Doing business as
Palm Bay Kidney Center
Practice address
220 Medplex Pkwy NE
Palm Bay, FL 32907-2560
Phone
(321) 722-2649
Fax
(321) 722-2716
NPI assigned
Jun 28, 2005
Last updated
May 7, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRAL FLORIDA KIDNEY CENTERS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Authorized official

Name
Amy Kozsuch
Title
Ceo
Phone
(407) 843-6110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

220 Medplex Pkwy NE
Palm Bay, FL 32907-2560

Mailing address

203 Ernestine Street
Orlando, FL 32801-3621
Phone (407) 843-6110

Other identifiers 2

IdentifierTypeStateIssuer
100626200MedicaidFL
200512301MedicaidFL

Other names 1

  • PALM BAY KIDNEY CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120418000463 FL Part A Provider - End-Stage Renal Disease Facility (ESRD) 1153235791 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orlando, FL
O20171226001876 FL Part A Provider - End-Stage Renal Disease Facility (ESRD) 1153235791 Practice locations: Palm Bay, FL

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Palm Bay Kidney CenterCCN 102651
Overall star rating
1.0 of 5
Ownership
Non-profit
Certified
Jan 2, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Central Florida Kidney Centers
Dialysis stations
18

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Part of
Central Florida Kidney Centers Inc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1952307589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 ERNESTINE STREET",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328013621",
            "telephone_number": "407-843-6110",
            "fax_number": "407-425-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MEDPLEX PKWY NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072560",
            "telephone_number": "321-722-2649",
            "fax_number": "321-722-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA KIDNEY CENTERS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL FLORIDA KIDNEY CENTERS, INC.",
        "enumeration_date": "2005-06-28",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "KOZSUCH",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-843-6110"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100626200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200512301",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALM BAY KIDNEY CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PALM BAY KIDNEY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.