SUNRISE PEDIATRICS LLC
NPI 1891939989
Pediatrics in Lake Wales, FL

Q: What is Sunrise Pediatrics LLC's NPI number?

The NPI number for Sunrise Pediatrics LLC is 1891939989. It was assigned to this organization in the NPPES registry on April 21, 2009.

Q: What is Sunrise Pediatrics LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since April 21, 2009CLIA 10D1100078 · Waiver

25103 HWY 27, LAKE WALES, FL 33859(863) 734-0344(877) 658-8666 Get Directions Write a Review

NPPES record last updated: November 27, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 27, 2025, Apr 25, 2019 (2 updates tracked since 2019).

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About Sunrise Pediatrics Llc NPPES

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

SUNRISE PEDIATRICS LLC (NPI 1891939989) is a healthcare organization registered as a pediatrics in Lake Wales, Florida and active in the NPI registry since April 2009. The organization holds a CLIA Waiver certificate valid through May 28, 2027 and lists Jagdeep Pruthi, Owner, as its authorized official.

NPPES Registry Identity

NPI1891939989

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameSUNRISE PEDIATRICS LLC

Location Address25103 HWY 27Lake Wales, FL 33859-6843

Mailing Address25103 Hwy 27Lake Wales, FL 33859-6843 · (863) 734-0344 · Fax (877) 658-8666

Phone(863) 734-0344

Fax(877) 658-8666

Organization SubpartNo

Authorized OfficialJagdeep PruthiOwner · (863) 734-0344

Enumeration DateApril 21, 2009

Last NPPES UpdateNovember 27, 20252 updates tracked since enumeration

NPPES CertifiedNovember 27, 2025

✔ NPI 1891939989 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

25103 HWY 27, Lake Wales, FL 33859

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sunrise Pediatrics Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateFloridaEnrollment IDO20090619000020Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Sunrise Pediatrics LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jagdeep Pruthi, M.D.

Pediatric Medicine

NPI 1609018183

25103 HWY 27
Lake Wales, FL 33859

(863) 734-0344

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 10D1100078

Sunrise Pediatrics LLC · Lake Wales, FL

Active · expires May 28, 2027

CLIA Number10D1100078

Laboratory TypePhysician Office

Certificate Effective DateMay 29, 2025

Certificate Expiration DateMay 28, 2027

Laboratory DirectorJagdeep S. Pruthi

Laboratory Phone(863) 734-0344

Laboratory LocationSunrise Pediatrics LLC25103 Hwy 27, Lake Wales, FL 33859

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Sunrise Pediatrics LLC's NPI number?

The NPI number for Sunrise Pediatrics LLC is 1891939989. It was assigned to this organization in the NPPES registry on April 21, 2009.

Where is Sunrise Pediatrics LLC located?

Sunrise Pediatrics LLC is located at 25103 Hwy 27, Lake Wales, FL 33859. The listed phone number is (863) 734-0344.

What is Sunrise Pediatrics LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Sunrise Pediatrics LLC enrolled in Medicare?

Yes. Sunrise Pediatrics LLC is registered in the Medicare PECOS enrollment system.

When is Sunrise Pediatrics LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Sunrise Pediatrics LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Pediatric Medicine) reassigns their Medicare billing to Sunrise Pediatrics LLC. 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.

Does Sunrise Pediatrics LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1100078) is associated with this NPI, valid through May 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sunrise Pediatrics LLC accept?

Health plans from Ambetter Health and Ambetter of Alabama list Sunrise Pediatrics 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 Sunrise Pediatrics LLC was last updated on November 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.