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LEGACY MEDICAL PLLC
NPI 1609647866
Internal Medicine - Nephrology in Palm Beach Gardens, FL

Active since January 15, 2024CLIA 10D2307320 · Waiver
11380 PROSPERITY FARMS RD STE 114, PALM BEACH GARDENS, FL 33410(917) 209-9990 Get Directions Write a Review

NPPES record last updated: January 15, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Legacy Medical Pllc NPPES

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

LEGACY MEDICAL PLLC (NPI 1609647866) is a healthcare organization registered as a nephrology in Palm Beach Gardens, Florida and active in the NPI registry since January 2024. The organization holds a CLIA Waiver certificate valid through July 7, 2028 and lists Yana Shtern, Authorized Member, as its authorized official.

NPPES Registry Identity

NPI1609647866
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameLEGACY MEDICAL PLLC
Location Address11380 PROSPERITY FARMS RD STE 114Palm Beach Gardens, FL 33410-3464
Mailing Address11380 Prosperity Farms Rd Ste 114Palm Beach Gardens, FL 33410-3464 · (917) 209-9990
Phone(917) 209-9990
Organization SubpartNo
Authorized OfficialYana ShternAuthorized Member · (917) 209-9990
Enumeration DateJanuary 15, 2024
NPPES CertifiedJanuary 15, 2024
✔ NPI 1609647866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedInternal MedicineTaxonomy 207R00000X
11380 PROSPERITY FARMS RD STE 114, Palm Beach Gardens, FL 33410
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 10D2307320

Legacy Medical PLLC · Palm Beach Gardens, FL
Active · expires Jul 7, 2028
CLIA Number10D2307320
Laboratory TypePhysician Office
Certificate Effective DateJuly 8, 2026
Certificate Expiration DateJuly 7, 2028
Laboratory DirectorYana Shtern
Laboratory Phone(561) 316-7199
Laboratory LocationLegacy Medical PLLC11380 Prosperity Farms Rd Ste 114, Palm Beach Gardens, FL 33410
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADISON HEBDA
Nurse Practitioner (Family)
11380 PROSPERITY FARMS RD STE 114
PALM BEACH GARDENS, FL 33410
Palm Beach County (772) 812-9374
DR. HARLAN CLAYTON BIELEY MD
General Practice
11380 PROSPERITY FARMS RD STE 114
PALM BEACH GARDENS, FL 33410
Palm Beach County (561) 842-7422
YANA SHTERN M.D.
Internal Medicine
11380 PROSPERITY FARMS RD STE 114
PALM BEACH GARDENS, FL 33410
Palm Beach County (561) 834-9280

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 Legacy Medical PLLC's NPI number?

The NPI number for Legacy Medical PLLC is 1609647866. It was assigned to this organization in the NPPES registry on January 15, 2024.

Where is Legacy Medical PLLC located?

Legacy Medical PLLC is located at 11380 Prosperity Farms Rd Ste 114, Palm Beach Gardens, FL 33410. The listed phone number is (917) 209-9990.

What is Legacy Medical PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Does Legacy Medical PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2307320) is associated with this NPI, valid through July 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Legacy Medical PLLC was last updated on January 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.