Unknown Individual – Emergency Medicine Physician, NPI 1255406344

Emergency Medicine Physician

Unknown Individual is a healthcare provider. based in Gulf breeze, Florida. specializing in Emergency Medicine Physician. They hold a License No. ME87832 (FL). The NPI Number for Unknown Individual is 1255406344

Main info

Organization

Inactive

26 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1255406344

Phone

(850) 529-1895

Address

3525 HILLSIDE AVE

Deactivation Date

31 January 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

6159286268

Graduation Year

2000 (26 years ago)

PAC ID

6305835620

Group Practice PAC ID

3577725068

Professional Enrollment ID

I20130325000212

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

3525 HILLSIDE AVE
GULF BREEZE, FL 325633321
Phone: (850) 529-1895
Type: Mailing
3869 PARADISE BAY DR
GULF BREEZE, FL 325632974
Phone: (850) 529-1895
Fax: (850) 529-1895
Type: Location

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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
99285	Emergency department visit with high level of medical decision making	99	97	$0
99284	Emergency department visit with moderate level of medical decision making	95	90	$0
93010	Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	60	48	$0

View full utilization report →

Insurance plans in this area (ZIP 32563)

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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: 3577725068View full group profile

Name	Specialty	State
LEAH SHEA WILLIAMSON	-	AL
Unknown Individual	-	AL
CAROL R. PARKS (M.D.)	-	TN
MICHAEL WAYNE PROCTOR (MD,FAAFP)	-	AL
MRS. PENNY BURCHAM	-	AL

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?

For Unknown Individual, use NPI 1255406344 as the unique 10-digit identifier.

Is inactive the same as retired for Unknown Individual?

Inactive registry status can reflect deactivation, consolidation, or data lag.

What area of care is associated with Unknown Individual?

Unknown Individual's record emphasizes Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.

Where in Florida is Unknown Individual registered?

Use Gulf Breeze, Florida as the headline location for Unknown Individual here.

What does 2 location(s) imply?

2 practice locations appear in the available data.

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