SUNRISE PEDIATRICS LLC – Pediatrics Physician, NPI 1891939989

SUNRISE PEDIATRICS LLC is a healthcare provider. based in Lake wales, Florida. specializing in Pediatrics Physician. The NPI Number for SUNRISE PEDIATRICS LLC is 1891939989

Main info

Organization
Name
SUNRISE PEDIATRICS LLC
NPI
1891939989
Phone
(863) 734-0344
Address
25103 HWY 27
Authorized Official
JAGDEEP PRUTHI OWNER MD
Enumeration Date
21 April 2009
Last Update Date
27 November 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness85
Years active:17State licenses:0Digital endpointsOther names

Provider Addresses for SUNRISE PEDIATRICS LLC

  • 25103 HWY 27

    LAKE WALES, FL 338596843

    Phone: (863) 734-0344

    Fax: (877) 658-8666

    Mailing address matches the actual address.

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: 2009-06-19

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20090619000020OClinic/Group PracticeFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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 33859)

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Reviews

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Frequently asked questions

Where can patients find SUNRISE PEDIATRICS LLC's NPI?
You can confirm SUNRISE PEDIATRICS LLC with NPI 1891939989; it appears in the national provider directory.
Does this profile mean SUNRISE PEDIATRICS LLC is currently active?
Yes — SUNRISE PEDIATRICS LLC appears active in the national provider directory.
What does SUNRISE PEDIATRICS LLC treat or focus on?
Patients typically see SUNRISE PEDIATRICS LLC under the specialty Pediatrics Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for SUNRISE PEDIATRICS LLC?
The page summarizes Lake Wales, Florida for SUNRISE PEDIATRICS LLC; expand the address list for detail.
How can I contact SUNRISE PEDIATRICS LLC?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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