Organization Active NPI

Universal Kidney Care LLC

  • Nephrology Physician
  • Jacksonville, FL
National Provider Identifier
1982141412
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
UNIVERSAL KIDNEY CARE LLC
Practice address
4600 Middleton Park Cir E Apt D250
Jacksonville, FL 32224-4684
Phone
(571) 635-9620
Fax
(866) 339-2911
NPI assigned
Jan 23, 2017
Last updated
Apr 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Waqas Ahmed, MDNPI 1700065091
Title
President/Owner
Phone
(571) 635-9620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

4600 Middleton Park Cir E Apt D250
Jacksonville, FL 32224-4684

Mailing address

10175 Fortune Pkwy Unit 302
Jacksonville, FL 32256-6749
Phone (571) 635-9620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180906000878 FL Part B Supplier - Clinic/Group Practice 7113204801 Receives reassigned benefits from 7 practitioners
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1982141412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY UNIT 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566749",
            "telephone_number": "571-635-9620",
            "fax_number": "866-339-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MIDDLETON PARK CIR E APT D250",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322244684",
            "telephone_number": "571-635-9620",
            "fax_number": "866-339-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL KIDNEY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "WAQAS",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "571-635-9620",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.