Unknown Individual – Orthopaedic Surgery Physician, NPI 1053406512

Unknown Individual is a healthcare provider. based in Fort walton beach, Florida. specializing in Orthopaedic Surgery Physician. They hold a License No. ME113059 (FL). The NPI Number for Unknown Individual is 1053406512

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1053406512
Phone
(850) 862-2663
Address
341 RACETRACK RD NW STE B
Deactivation Date
16 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8509163700
Graduation Year
1994 (32 years ago)
PAC ID
2668651266
Group Practice PAC ID
7517018146
Professional Enrollment ID
I20110128000369
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

  • 341 RACETRACK RD NW STE B

    SUITE 114

    FORT WALTON BEACH, FL 325471552

    Phone: (850) 862-2663

    Fax: (850) 862-0188

    Type: Location

  • 6262, Veterans Parkway, Ogletree Woods, Columbus, Muscogee County, Georgia, 31909, United States

    COLUMBUS, GA 319093540

    Phone: (706) 324-6661

    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 $244.

Total Amount is formed as General ($244) + Research ($0) + Ownership ($0) = $244.

Last reported payment date: 2024-03-25 • Largest payer in this snapshot: Cgg Medical Inc ($149).

Total Amount

$244

General + Research + Ownership

Payments

2

Total payment records

General Amount

$244

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-25

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Cgg Medical Inc$149
CGG Medical Inc$95
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
J7328Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg7,05611$0
J7318Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg1,08011$0
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg50061$0
99213Established patient office or other outpatient visit, 20-29 minutes226124$0
20610Aspiration and/or injection of fluid from large joint13767$0
View full utilization report →

Insurance plans in this area (ZIP 32547)

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Provider's Procedures

Unknown Individual performs procedures in Orthopaedic Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYFL73562X-ray of knee, 3 views2929

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: 7517018146View full group profile

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1053406512 uniquely identifies Unknown Individual in U.S. healthcare data.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Orthopaedic Surgery Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Fort Walton Beach, Florida?
For routing, start with Fort Walton Beach, Florida for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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