Organization Active NPI

SMB Surgical LLC

  • Surgery Physician
  • Bayamon, PR
National Provider Identifier
1487486254
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SMB SURGICAL LLC
Practice address
70 Calle Santa Cruz
Bayamon, PR 00961-7052
Phone
(787) 620-4747
NPI assigned
Aug 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Authorized official

Name
Sofia Marcano Bonilla, MDNPI 1538699533
Title
President
Phone
(787) 479-1690

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
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

70 Calle Santa Cruz
Bayamon, PR 00961-7052

Mailing address

Torrimar Calle Cordoba 330
Guaynabo, PR 00969-3207
Phone (787) 479-1690

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241104003948 PR Part B Supplier - Clinic/Group Practice 4284167859 Receives reassigned benefits from 1 practitioner
Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1487486254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TORRIMAR CALLE CORDOBA 330",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009693207",
            "telephone_number": "787-479-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 CALLE SANTA CRUZ",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617052",
            "telephone_number": "787-620-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMB SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "MARCANO BONILLA",
        "authorized_official_first_name": "SOFIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-479-1690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.