Unknown Individual – Family Medicine Physician, NPI 1770538217

Unknown Individual is a healthcare provider. based in Big bear lake, California. specializing in Family Medicine Physician. They hold a License No. G42774 (CA). The NPI Number for Unknown Individual is 1770538217

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1770538217
Phone
(909) 866-5868
Address
PO BOX 6848 PMB 278
Deactivation Date
15 May 2025

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1979 (47 years ago)
PAC ID
9739071887
Professional Enrollment ID
I20040325000805
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • PO BOX 6848 PMB 278

    BIG BEAR LAKE, CA 92315

    Phone: (909) 866-5868

    Fax: (909) 866-5860

    Type: Mailing

  • 41933 Big Bear Blvd.

    Big Bear Lake, CA 923151649

    Phone: (909) 866-5868

    Fax: (909) 866-5860

    Type: Location

  • 41945 BIG BEAR BLVD STE 200

    BIG BEAR LAKE, CA 923152030

    Phone: (909) 866-5868

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $41.

Total Amount is formed as General ($41) + Research ($0) + Ownership ($0) = $41.

Last reported payment date: 2023-11-22 • Largest payer in this snapshot: PFIZER INC. ($24).

Total Amount

$41

General + Research + Ownership

Payments

2

Total payment records

General Amount

$41

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-22

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
99214Established patient office or other outpatient visit, 30-39 minutes571181$0
99213Established patient office or other outpatient visit, 20-29 minutes374148$0
81002Urinalysis, manual test11460$0
96372Injection of drug or substance under skin or into muscle1611$0
99215Established patient office or other outpatient visit, 40-54 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 92315)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
EMERGENCY MEDICINECA17003Destruction of 2-14 skin growths12513
EMERGENCY MEDICINECA81002Urinalysis, manual test175116

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1770538217 on file in the registry.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in California is Unknown Individual registered?
Use Big Bear Lake, California as the headline location for Unknown Individual here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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