Individual provider Active NPI

Bibiana Rocio Sandoval, MD, MPH

  • Family Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1073190690
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A197107 Issued in CA
Practice address
10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111
Phone
(772) 345-8100
NPI assigned
Mar 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A197107 CA Primary

Addresses

Primary practice location

10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111

Mailing address

11455 SW Village Pkwy Apt 307
Port Saint Lucie, FL 34987-2665
Phone (754) 317-1938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251026000150 FL Practitioner - Family Practice 9133504301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2100 SE Salerno Rd
Stuart, FL 34997-6503
Phone (772) 223-2300

Hospital & facility affiliations

  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A197107CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Oct 20, 2025 Accepting new patients
Martin Memorial Medical Center Inc Current Accepting new patients

Locations

10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853

2100 SE Salerno Rd
Stuart, FL 34997
Phone (772) 223-2300

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1073190690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11455 SW VILLAGE PKWY APT 307",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872665",
            "telephone_number": "754-317-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SW INNOVATION WAY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872111",
            "telephone_number": "772-345-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "BIBIANA",
        "middle_name": "ROCIO",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-28",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A197107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.