Organization Active NPI

Sabucedo Nephrology Group Inc

  • Nephrology Physician
  • South Miami, FL
National Provider Identifier
1336645936
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME117297 Issued in FL
Legal business name
SABUCEDO NEPHROLOGY GROUP INC
Practice address
6140 SW 70TH St FL 2
South Miami, FL 33143-3419
Phone
(305) 793-0605
NPI assigned
Apr 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Alberto J Sabucedo, MDNPI 1033418512
Title
President
Phone
(305) 793-0605

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME117297 FL
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X ME117297 FL Primary

Addresses

Primary practice location

6140 SW 70TH St FL 2
South Miami, FL 33143-3419

Mailing address

690 W Park Dr Apt 208
Miami, FL 33172-5325
Phone (305) 793-0605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181031000594 FL Part B Supplier - Clinic/Group Practice 7416200910 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

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": "1522713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1336645936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 W PARK DR APT 208",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331725325",
            "telephone_number": "305-793-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 SW 70TH ST FL 2",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331433419",
            "telephone_number": "305-793-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SABUCEDO NEPHROLOGY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "SABUCEDO",
        "authorized_official_first_name": "ALBERTO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-793-0605",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME117297",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME117297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.