Unknown Individual – Pulmonary Disease Physician, NPI 1043248461

Unknown Individual is a healthcare provider. based in Jacksonville, Florida. specializing in Pulmonary Disease Physician. They hold a License No. ME44534 (FL). The NPI Number for Unknown Individual is 1043248461

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1043248461
Phone
(904) 354-8200
Address
425 N LEE ST
Deactivation Date
1 May 2025

Doctor Profile

Medical School Name
WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9043548200
Graduation Year
1977 (49 years ago)
PAC ID
0345399531
Group Practice PAC ID
2860411188
Professional Enrollment ID
I20100818000929
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

  • 425, Lee Street, LaVilla, Jacksonville, Duval County, Florida, 32204, United States

    203

    JACKSONVILLE, FL 322041128

    Phone: (904) 354-8200

    Fax: (904) 354-1340

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32204)

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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: 2860411188View full group profile

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1043248461 when you need to reference Unknown Individual in forms, claims, or directories.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Pulmonary Disease Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Jacksonville, Florida for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1043248461. Always confirm identity and privileges with the practice and licensing boards.

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