PROVO KIDNEY CARE LLC – Nephrology Physician, NPI 1972056893

PROVO KIDNEY CARE LLC is a healthcare provider. based in Waltham, Massachusetts. specializing in Nephrology Physician. The organization holds a License No. 001 (UT). The NPI Number for PROVO KIDNEY CARE LLC is 1972056893

Main info

Organization
Name
PROVO KIDNEY CARE LLC
NPI
1972056893
Phone
(480) 639-7186
Address
920 WINTER ST
Authorized Official
PAMELA VP VICE PRESIDENT
Enumeration Date
27 July 2016
Last Update Date
27 July 2016
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

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Provider Addresses for PROVO KIDNEY CARE LLC

  • 920, Winter Street, Prospectville, Waltham, Middlesex County, Massachusetts, 01773, United States

    WALTHAM, MA 024511521

    Phone: (480) 639-7186

    Fax: (602) 798-8267

    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

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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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 02451)

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Reviews

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Frequently asked questions

What is PROVO KIDNEY CARE LLC's NPI number?
PROVO KIDNEY CARE LLC's NPI is 1972056893 — the number used across U.S. healthcare to identify this provider.
Would PROVO KIDNEY CARE LLC appear as active to a payer?
You can treat PROVO KIDNEY CARE LLC as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to PROVO KIDNEY CARE LLC?
PROVO KIDNEY CARE LLC's specialty line reads Nephrology Physician. Clinical services aligned with this taxonomy classification.
Is PROVO KIDNEY CARE LLC located near Waltham?
PROVO KIDNEY CARE LLC currently maps to Waltham, Massachusetts in this extract.
Does PROVO KIDNEY CARE LLC accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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