Organization Active NPI

SMB Medical, PC

  • Physical Medicine & Rehabilitation Physician
  • Rego Park, NY
National Provider Identifier
1205004181
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
231488 Issued in NY
Legal business name
SMB MEDICAL, PC
Practice address
9522 63Rd Rd
531
Rego Park, NY 11374-1142
Phone
(718) 271-3548
Fax
(718) 606-0719
NPI assigned
Feb 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
Stephanie Bayner, MDNPI 1942246673
Title
Owner
Phone
(718) 271-3548

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 231488 NY Primary

Addresses

Primary practice location

9522 63Rd Rd
531
Rego Park, NY 11374-1142

Mailing address

9522 63Rd Rd
#531
Rego Park, NY 11374-1142
Phone (718) 271-3548

Other identifiers 1

IdentifierTypeStateIssuer
231488OtherNYLICENSE

National Provider Directory

National Provider Directory
Tax ID family
SMB Medical PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1205004181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9522 63RD RD",
            "address_2": "#531",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741142",
            "telephone_number": "718-271-3548",
            "fax_number": "718-606-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9522 63RD RD",
            "address_2": "531",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741142",
            "telephone_number": "718-271-3548",
            "fax_number": "718-606-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMB MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "BAYNER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-271-3548",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "231488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "231488",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.