Unknown Individual – Podiatrist, NPI 1043292378

Unknown Individual is a healthcare provider. based in Port charlotte, Florida. specializing in Podiatrist. They hold a License No. PO2884 (FL). The NPI Number for Unknown Individual is 1043292378

Main info

Organization
Inactive
28 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1043292378
Phone
(941) 613-1919
Address
3191 HARBOR BLVD
Deactivation Date
27 February 2025

Doctor Profile

Medical School Name
KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
9416131919
Graduation Year
1998 (28 years ago)
PAC ID
3779541891
Group Practice PAC ID
2668480070
Professional Enrollment ID
I20041221000646
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

  • 3191, Harbor Boulevard, Port Charlotte, Charlotte County, Florida, 33952, United States

    UNIT D

    PORT CHARLOTTE, FL 339526755

    Phone: (941) 613-1919

    Fax: (941) 613-4077

    Type: Mailing

  • 3191 HARBOR BLVD STE D

    PORT CHARLOTTE, FL 339526755

    Phone: (941) 613-1919

    Fax: (941) 613-4077

    Type: Mailing

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 $29.

Total Amount is formed as General ($29) + Research ($0) + Ownership ($0) = $29.

Last reported payment date: 2023-05-08 • Largest payer in this snapshot: Lilly USA, LLC ($17).

Total Amount

$29

General + Research + Ownership

Payments

2

Total payment records

General Amount

$29

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-08

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Lilly USA, LLC$17
Dexcom, Inc.$13
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
99213Established patient office or other outpatient visit, 20-29 minutes14085$0
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg5016$0
99203New patient office or other outpatient visit, 30-44 minutes4646$0
11721Removal of fingernails or toenails, 6 or more nails3724$0
11730Simple separation of fingernail or toenail from nail bed, first nail2724$0
View full utilization report →

Insurance plans in this area (ZIP 33952)

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Provider's Procedures

Unknown Individual performs procedures in Podiatrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYFL11042Removal of skin and tissue first 20 sq cm or less10543
PODIATRYFL11056Removal of 2 to 4 thickened skin growths16792
PODIATRYFL11101Biopsy of each additional growth of skin and/or tissue1919

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1043292378; it appears in the national provider directory.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Podiatrist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Port Charlotte, Florida for Unknown Individual based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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