Unknown Individual – Physician Assistant, NPI 1164429346
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
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Provider Addresses for Unknown Individual
Benmore Drive, Winter Park, Orange County, Florida, 32792, United States
SUITE 100
WINTER PARK, FL 327924143
Phone: (407) 644-4883
Fax: (407) 644-3697
Type: Location
133, Benmore Drive, Winter Park, Orange County, Florida, 32792, United States
SUITE 100
WINTER PARK, FL 327924143
Phone: (407) 644-4883
Fax: (407) 644-3697
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $136.
Total Amount is formed as General ($136) + Research ($0) + Ownership ($0) = $136.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: GENZYME CORPORATION ($95).
Total Amount
$136
General + Research + Ownership
Payments
3
Total payment records
General Amount
$136
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GENZYME CORPORATION | $95 |
| Inspire Medical Systems, Inc. | $27 |
| Hikma Pharmaceuticals USA | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100927000174 | I | Physician Assistant | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 69210 | Removal of impacted ear wax | 633 | 387 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 365 | 230 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 333 | 250 | $0 |
| 92504 | Exam of ear using a microscope | 120 | 69 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 73 | 73 | $0 |
Insurance plans in this area (ZIP 32792)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O T O L A R Y N G O L O G Y | TX | |
| - | FL | |
| O T O L A R Y N G O L O G Y | TX | |
| O T O L A R Y N G O L O G Y | FL | |
| O T O L A R Y N G O L O G Y | FL | |
| Qualified Audiologist | FL | |
| Qualified Audiologist | FL | |
| O T O L A R Y N G O L O G Y | FL | |
| O T O L A R Y N G O L O G Y | FL | |
| O T O L A R Y N G O L O G Y | FL |
Reviews
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