Unknown Individual – Podiatrist, NPI 1700896529

Unknown Individual is a healthcare provider. based in Victorville, California. specializing in Podiatrist. They hold a License No. E4143 (CA). The NPI Number for Unknown Individual is 1700896529

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1700896529
Phone
(760) 951-0065
Address
15030 7TH ST
Deactivation Date
11 November 2023

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Secondary Phone
3232646157
Graduation Year
1995 (31 years ago)
PAC ID
9234310624
Group Practice PAC ID
2163411075
Professional Enrollment ID
I20110217000579
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 15030, 7th Street, Victorville, San Bernardino County, California, 92395, United States

    VICTORVILLE, CA 923953811

    Phone: (760) 951-0065

    Fax: (760) 951-5382

    Type: Location

  • 2150 N Waterman Ave Ste 300

    San Bernardino, CA 924044811

    Phone: (760) 951-0065

    Fax: (760) 951-5382

    Type: Location

  • 3616 E 1st St

    Los Angeles, CA 900632326

    Phone: (323) 264-6157

    Fax: (323) 264-0099

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $164.

Total Amount is formed as General ($164) + Research ($0) + Ownership ($0) = $164.

Last reported payment date: 2023-09-07 • Largest payer in this snapshot: BIOTISSUE HOLDINGS, INC. ($113).

Total Amount

$164

General + Research + Ownership

Payments

5

Total payment records

General Amount

$164

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-07

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99215Established patient office or other outpatient visit, 40-54 minutes52773$0
97610Therapy procedure using ultrasound29318$0
11042Removal of skin and tissue, 20.0 sq cm or less7016$0
11721Removal of fingernails or toenails, 6 or more nails4228$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes3426$0
View full utilization report →

Insurance plans in this area (ZIP 92395)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163411075View full group profile
NameSpecialtyState
P O D I A T R YCA
P O D I A T R YCA
P O D I A T R YCA
P O D I A T R YCA
-CA
-CA

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1700896529.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Podiatrist in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Victorville, California may find Unknown Individual in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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