Organization Active NPI

SG Primary Care MD, LLC

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1548898646
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SG PRIMARY CARE MD, LLC
Practice address
8200 SW 117TH Ave
Miami, FL 33183-3856
Phone
(305) 274-6422
Fax
(305) 274-5707
NPI assigned
Apr 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Authorized official

Name
Sergio Garcia, MDNPI 1548462740
Title
Owner
Phone
(305) 274-6422

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

8200 SW 117TH Ave
Miami, FL 33183-3856

Mailing address

8200 SW 117TH Ave
Miami, FL 33183-3856
Phone (305) 274-6422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200520001678 FL Part B Supplier - Clinic/Group Practice 9335570654 Receives reassigned benefits from 2 practitioners
Practice locations: Miami, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2066145SG Primary Care MD LLC8200 SW 117TH Ave Ste 316, Miami, FL 33183Certificate of waiverSep 22, 2027

National Provider Directory

National Provider Directory

Locations

8200 SW 117th Ave
Miami, FL 33183
Phone (305) 226-5651

8200 SW 117th Ave
Ste 314
Miami, FL 33183
Phone (305) 274-6422

Practitioners & affiliated clinicians

Practitioners 5

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": "1585699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1548898646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 SW 117TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331833856",
            "telephone_number": "305-274-6422",
            "fax_number": "305-274-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 SW 117TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331833856",
            "telephone_number": "305-274-6422",
            "fax_number": "305-274-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SG PRIMARY CARE MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-01",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-274-6422",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.