Unknown Individual – Dermatology Physician, NPI 1043228893

Unknown Individual is a healthcare provider. based in Boca raton, Florida. specializing in Dermatology Physician. They hold a License No. ME0047923 (FL). The NPI Number for Unknown Individual is 1043228893

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1043228893
Phone
(561) 395-7704
Address
2499 W. GLADES RD
Deactivation Date
5 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9544263494
Graduation Year
1981 (45 years ago)
PAC ID
1153224548
Group Practice PAC ID
1153390414
Professional Enrollment ID
I20040202000267
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

  • Glades Road, Boca Raton, Palm Beach County, Florida, 33432, United States

    SUITE 310

    BOCA RATON, FL 334317202

    Phone: (561) 395-7704

    Fax: (561) 395-8860

    Type: Mailing

  • Holiday Inn Express Boca Raton-West, Glades Road, Boca West, Palm Beach County, Florida, 33434, United States

    SUITE 310

    BOCA RATON, FL 334317202

    Phone: (561) 395-7704

    Fax: (561) 395-8860

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 13 Open Payments records for all available years, with a total value of $533.

Total Amount is formed as General ($533) + Research ($0) + Ownership ($0) = $533.

Last reported payment date: 2024-03-28 • Largest payer in this snapshot: Amgen Inc. ($148).

Total Amount

$533

General + Research + Ownership

Payments

13

Total payment records

General Amount

$533

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-28

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
17003Destruction of precancer skin growth, 2-14 growths948170$0
99213Established patient office or other outpatient visit, 20-29 minutes563275$0
17000Destruction of precancer skin growth, 1 growth392218$0
11102Biopsy of related skin growth, first growth385241$0
11103Biopsy of related skin growth, each additional growth293147$0
View full utilization report →

Insurance plans in this area (ZIP 33431)

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Provider's Procedures

Unknown Individual performs procedures in Dermatology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYFL11101Biopsy of each additional growth of skin and/or tissue1622457

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: 1153390414View full group profile
NameSpecialtyState
General SurgeryFL
D E R M A T O L O G YFL
Physician AssistantFL
Nurse PractitionerFL
D E R M A T O L O G YFL
D E R M A T O L O G YFL
Nurse PractitionerFL
D E R M A T O L O G YFL
Physician AssistantFL
Physician AssistantFL

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1043228893 in the public NPI dataset.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Dermatology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Boca Raton, Florida in our summary view.
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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