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LAKE MARY DIALYSIS
NPI 1083031223
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Lake Mary, FL

Active since March 26, 2014CLIA 10D2079629 · Waiver
1/5
Overall Rating
39 SKYLINE DR, STE 1001, LAKE MARY, FL 32746(407) 833-8667(407) 833-8672 Get Directions Write a Review

NPPES record last updated: August 12, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 12, 2024, Jul 29, 2019 (2 updates tracked since 2019).

About Lake Mary Dialysis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE MARY DIALYSIS (NPI 1083031223) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Lake Mary, Florida and active in the NPI registry since March 2014. The organization holds a CLIA Waiver certificate valid through June 18, 2028 and lists Samuel T. Wey, Vp, Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1083031223
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameLOURDES DIALYSIS, LLC
Location Address39 SKYLINE DR, STE 1001Lake Mary, FL 32746-7123
Mailing Address5200 Virginia Way, L&c DeptBrentwood, TN 37027-7569
Phone(407) 833-8667
Fax(407) 833-8672
Organization SubpartNo
Authorized OfficialSamuel T. WeyVp, Licensure & Certification · (615) 341-6641
Enumeration DateMarch 26, 2014
Last NPPES UpdateAugust 12, 20242 updates tracked since enumeration
NPPES CertifiedAugust 12, 2024
✔ NPI 1083031223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
39 SKYLINE DR, Lake Mary, FL 32746
Open in Google Maps ↗

Other Names 1

Doing Business AsLake Mary Dialysis

Other Identifiers 1

Medicaid014268500FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2079629

Lake Mary Dialysis · Lake Mary, FL
Active · expires Jun 18, 2028
CLIA Number10D2079629
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateJune 19, 2026
Certificate Expiration DateJune 18, 2028
Laboratory DirectorIvan D. Maya
Laboratory Phone(407) 833-8667
Laboratory LocationLake Mary Dialysis39 Skyline Dr Ste 1001, Lake Mary, FL 32746
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for DaVita Lake Mary Dialysis (CMS certification number 682567), from CMS Care Compare.

DaVita Lake Mary Dialysis

Dialysis facility · Lake Mary, FL
1/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainDaVita
CMS Certification Number682567
ESRD NetworkNetwork 7
Hemodialysis Stations20
Medicare-Certified SinceNovember 24, 2014
Location39 SKYLINE DR #1001Lake Mary, FL 32746 · Seminole County
Phone(407) 833-8667
Services Offered
In-center hemodialysis Peritoneal dialysis Home hemodialysis training

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lourdes Dialysis, LLC's NPI number?

The NPI number for Lourdes Dialysis, LLC is 1083031223. It was assigned to this organization in the NPPES registry on March 26, 2014. The provider is doing business as Lake Mary Dialysis.

Where is Lourdes Dialysis, LLC located?

Lourdes Dialysis, LLC is located at 39 Skyline Dr Ste 1001, Lake Mary, FL 32746. The listed phone number is (407) 833-8667.

What is Lourdes Dialysis, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Lourdes Dialysis, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2079629) is associated with this NPI, valid through June 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Lourdes Dialysis, LLC a Medicare-certified dialysis facility?

Yes. DaVita Lake Mary Dialysis is a Medicare-certified dialysis facility, certified since November 24, 2014.

What quality rating does Lourdes Dialysis, LLC have?

CMS rates DaVita Lake Mary Dialysis 1 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

What insurance does Lourdes Dialysis, LLC accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 11 other insurers list Lourdes Dialysis, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lourdes Dialysis, LLC was last updated on August 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.