Memorial Division of Pediatric Nephrology – Pediatric Nephrology Physician, NPI 1467468496
Pediatric Nephrology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Memorial Division of Pediatric Nephrology
1865 N Corporate Lakes Blvd Ste 1
Weston, FL 333263273
Phone: (954) 265-9344
Fax: (954) 986-5122
Type: Location
900 Glades Rd Ste 501
Boca Raton, FL 334316421
Phone: (954) 265-9344
Fax: (954) 986-5122
Type: Location
1150 N 35th Ave Ste 490
Hollywood, FL 330215423
Phone: (954) 265-3437
Fax: (954) 983-5052
Type: Location
1971 SW 172nd Ave Ste 2500
Miramar, FL 330295621
Phone: (954) 265-9344
Fax: (954) 265-9343
Type: Location
3377 S State Road 7 Ste 100
Wellington, FL 334498002
Phone: (561) 341-7000
Fax: (561) 341-7015
Type: Location
1131 N 35TH AVE STE 210
HOLLYWOOD, FL 330215403
Phone: (954) 265-9344
Fax: (954) 265-3676
Type: Location
2900, Corporate Way, Miramar, Broward County, Florida, 33025, United States
MIRAMAR, FL 330253925
Phone: (954) 276-5685
Fax: (954) 985-7074
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2004-02-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
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 |
|---|---|---|---|---|
| O20040209000093 | O | Clinic/Group Practice | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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 33326)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.