Unknown Individual – Interventional Pain Medicine Physician, NPI 1164472239

Unknown Individual is a healthcare provider. based in Coral springs, Florida. specializing in Interventional Pain Medicine Physician. They hold a License No. ME66192 (FL). The NPI Number for Unknown Individual is 1164472239

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1164472239
Phone
(954) 975-8233
Address
8880 ROYAL PALM BLVD
Deactivation Date
19 December 2024

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
Secondary Phone
9549758233
Graduation Year
1990 (36 years ago)
PAC ID
1355241027
Group Practice PAC ID
5294734596
Professional Enrollment ID
I20040109000603
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

  • 8880, Royal Palm Boulevard, Coral Springs, Broward County, Florida, 33065, United States

    SUITE 103

    CORAL SPRINGS, FL 33065

    Phone: (954) 975-8233

    Fax: (954) 974-2335

    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)

CMS reports 7 Open Payments records for all available years, with a total value of $269.

Total Amount is formed as General ($269) + Research ($0) + Ownership ($0) = $269.

Last reported payment date: 2024-08-30 • Largest payer in this snapshot: Medtronic, Inc. ($221).

Total Amount

$269

General + Research + Ownership

Payments

7

Total payment records

General Amount

$269

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-30

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Medtronic, Inc.$221
Nevro Corp.$47
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
99214Established patient office or other outpatient visit, 30-39 minutes366141$0
99213Established patient office or other outpatient visit, 20-29 minutes10173$0
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg9926$0
Q9966Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml8626$0
99204New patient office or other outpatient visit, 45-59 minutes7878$0
View full utilization report →

Insurance plans in this area (ZIP 33065)

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Provider's Procedures

Unknown Individual performs procedures in Interventional Pain Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PAIN MANAGEMENTFL64493Injections of lower or sacral spine facet joint using imaging guidance5149

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: 5294734596View full group profile
NameSpecialtyState
Interventional Pain ManagementFL
Physical Medicine And Rehabilitation, Interventional Pain ManagementFL

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1164472239.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Interventional Pain Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Coral Springs, Florida in the same public data insurers reference.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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