Unknown Individual – Internal Medicine Physician, NPI 1003897737

Unknown Individual is a healthcare provider. based in Lake worth, Florida. specializing in Internal Medicine Physician. They hold a License No. 5101017288 (MI). The NPI Number for Unknown Individual is 1003897737

Main info

Organization
Inactive
21 Years Of Experience
Name
Unknown Individual
NPI
1003897737
Phone
(561) 568-1272
Address
400 S DIXIE HWY
Deactivation Date
29 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2005 (21 years ago)
PAC ID
9436274172
Professional Enrollment ID
I20100917000418
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 400, Dixie Highway, Lake Worth Beach, Palm Beach County, Florida, 33460, United States

    SUITE 12

    LAKE WORTH, FL 334604457

    Phone: (561) 568-1272

    Fax: (561) 345-3521

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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 minutes5216$0
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Insurance plans in this area (ZIP 33460)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1003897737.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Internal Medicine Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Lake Worth, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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