Unknown Individual – Surgery Physician, NPI 1639174063
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
50, Bellefontaine Street, Pasadena, Los Angeles County, California, 91105, United States
STE 303
PASADENA, CA 911053132
Phone: (626) 793-4136
Fax: (626) 793-8279
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $55.
Total Amount is formed as General ($55) + Research ($0) + Ownership ($0) = $55.
Last reported payment date: 2023-12-21 • Largest payer in this snapshot: Smith+Nephew, Inc. ($29).
Total Amount
$55
General + Research + Ownership
Payments
4
Total payment records
General Amount
$55
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Smith+Nephew, Inc. | $29 |
| KCI USA, Inc. | $13 |
| Hologic Sales and Service, LLC | $13 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 271 | 51 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 228 | 50 | $0 |
| 99183 | Management of oxygen chamber therapy | 115 | 18 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 108 | 37 | $0 |
| 11045 | Removal of skin and tissue, each additional 20.0 sq cm or less | 69 | 18 | $0 |
Insurance plans in this area (ZIP 91105)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | CA | 11042 | Removal of skin and tissue first 20 sq cm or less | 408 | 73 |
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