LEGACY DIALYSIS OF FAIRFAX LLC – End-Stage Renal Disease (ESRD) Treatment Clinic/Center, NPI 1427534072
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for LEGACY DIALYSIS OF FAIRFAX LLC
50 E SAMPLE RD STE 301
POMPANO BEACH, FL 330643552
Phone: (954) 781-7741
Fax: (888) 349-8679
Type: Mailing
East Sample Road, Pompano Beach, Broward County, Florida, 33064, United States
POMPANO BEACH, FL 330643554
Phone: (954) 781-7741
Fax: (888) 349-8679
Type: Mailing
205, Boulevard, Fairfax, Valley, Chambers County, Alabama, 36854, United States
FAIRFAX, VA 220303104
Phone: (571) 340-3221
Fax: (571) 340-3404
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-02-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-04-30 (43 days ago).
Enrollment records
1
Earliest due date
2026-04-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20200228002093 | O | End-Stage Renal Disease Facility (Esrd) | VA | 2026-04-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33064)
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