Unknown Individual – Surgery Physician, NPI 1164580593

Unknown Individual is a healthcare provider. based in Seminole, Florida. specializing in Surgery Physician. They hold a License No. MD-13596 (HI). The NPI Number for Unknown Individual is 1164580593

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1164580593
Phone
(727) 393-0143
Address
13581 HERITAGE DR
Deactivation Date
4 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3013742047
Graduation Year
1968 (58 years ago)
PAC ID
4587791900
Group Practice PAC ID
8729022736
Professional Enrollment ID
I20100416000184
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:0State licenses:3Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Heritage Commons Drive, Heritage Commons, Seminole County, Florida, 32972, United States

    SEMINOLE, FL 337763449

    Phone: (727) 393-0143

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93971Ultrasound study of one arm or leg veins with compression and maneuvers2,339855$0
93970Ultrasound study of arm or leg veins with compression and maneuvers2,1671,710$0
View full utilization report →

Insurance plans in this area (ZIP 33776)

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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: 8729022736View full group profile
NameSpecialtyState
Emergency MedicineMD
Emergency MedicineMD
Internal MedicineNY
Emergency Medicine, Internal MedicineMD
Cardiovascular Disease (Cardiology), Internal MedicineNJ
Physician AssistantGA
Nurse PractitionerUT
-VA
Emergency MedicineMD
Diagnostic Radiology, Interventional Radiology, Obstetrics/Gynecology, Interventional RadiologyNJ

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1164580593 is assigned to Unknown Individual under the national enumeration system.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Surgery Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Seminole, Florida for Unknown Individual; expand the address list for detail.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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