Unknown Individual – Neurology Physician, NPI 1043207657

Unknown Individual is a healthcare provider. based in Jacksonville, Florida. specializing in Neurology Physician. They hold a License No. ME78987 (FL). The NPI Number for Unknown Individual is 1043207657

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1043207657
Phone
(904) 376-4400
Address
PO BOX 41113
Deactivation Date
24 July 2025

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9042491041
Graduation Year
1995 (31 years ago)
PAC ID
4082758305
Group Practice PAC ID
0345366704
Professional Enrollment ID
I20100224000229
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

Provider Addresses for Unknown Individual

  • PO BOX 41113

    JACKSONVILLE, FL 322031113

    Phone: (904) 376-4400

    Fax: (904) 249-9764

    Type: Mailing

  • 1370 13TH AVE S STE 215

    JACKSONVILLE BEACH, FL 322503206

    Phone: (904) 249-1041

    Fax: (904) 249-9764

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 177 Open Payments records for all available years, with a total value of $4,152.

Total Amount is formed as General ($4,152) + Research ($0) + Ownership ($0) = $4,152.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($461).

Total Amount

$4,152

General + Research + Ownership

Payments

177

Total payment records

General Amount

$4,152

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

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 minutes311240$0
99213Established patient office or other outpatient visit, 20-29 minutes196162$0
99215Established patient office or other outpatient visit, 40-54 minutes143125$0
95886Needle measurement of electrical activity in arm or leg muscles, complete study138101$0
99205New patient office or other outpatient visit, 60-74 minutes7171$0
View full utilization report →

Insurance plans in this area (ZIP 32203)

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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: 0345366704View full group profile
NameSpecialtyState
N E U R O L O G YFL
N E U R O L O G YGA
Nurse PractitionerGA
Nurse PractitionerGA
-FL
Neurology, EpileptologistsGA
Neurology, OphthalmologyFL
N E U R O L O G YFL
Nurse PractitionerFL
N E U R O L O G YFL

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1043207657 uniquely identifies Unknown Individual in U.S. healthcare data.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Neurology Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Jacksonville, Florida in registry-derived data.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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