LONESTAR NEPHROLOGY PLLC
NPI 1104538651
Internal Medicine - Nephrology in Bryan, TX
About Lonestar Nephrology Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LONESTAR NEPHROLOGY PLLC (NPI 1104538651) is a healthcare organization registered as a nephrology in Bryan, Texas and active in the NPI registry since December 2022. The organization lists Prosperity Ezeanuna, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lonestar Nephrology Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Lonestar Nephrology PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Lonestar Nephrology PLLC's NPI number?
The NPI number for Lonestar Nephrology PLLC is 1104538651. It was assigned to this organization in the NPPES registry on December 15, 2022.
Where is Lonestar Nephrology PLLC located?
Lonestar Nephrology PLLC is located at 2310 De Lee St Ste 300, Bryan, TX 77802. The listed phone number is (979) 485-9401.
What is Lonestar Nephrology PLLC's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is Lonestar Nephrology PLLC enrolled in Medicare?
Yes. Lonestar Nephrology PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lonestar Nephrology PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Lonestar Nephrology PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Lonestar Nephrology PLLC was last updated on December 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Lonestar Nephrology Pllc · NPI 1104538651
Nephrology organization in Bryan, Texas. Organization record, active in the CMS NPPES registry since December 15, 2022.
## Identity
- **NPI:** 1104538651 (Entity type: Organization)
- **Enumerated:** December 15, 2022
- **Primary specialty:** Internal Medicine - Nephrology · taxonomy 207RN0300X
- **Organization subpart:** No
- **Authorized official:** Prosperity Ezeanuna, PRESIDENT
## Practice location
- **Address:** 2310 DE LEE ST STE 300, Bryan, TX 77802-2815
- **Phone:** (979) 485-9401
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 15, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1104538651) · Data from the CMS NPPES public registry.