Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1265764567

Unknown Individual is a healthcare provider. based in Sunrise, Florida. specializing in Certified Registered Nurse Anesthetist. They hold a License No. AP60129871 (WA). The NPI Number for Unknown Individual is 1265764567

Main info

Organization
Inactive
17 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1265764567
Phone
(800) 437-2672
Address
1613 HARRISON PKWY
Deactivation Date
26 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5864271000
Graduation Year
2009 (17 years ago)
PAC ID
2163558214
Group Practice PAC ID
3971898644
Professional Enrollment ID
I20100329000652
Data current as of
20 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

  • Sunrise, Harrison County, Kentucky, United States

    SUNRISE, FL 333232896

    Phone: (800) 437-2672

    Fax: (954) 851-1736

    Type: Mailing

  • Capital Mall Dr and Yauger Way [wb], 3900, Capitol Mall Drive Southwest, Olympia, Thurston County, Washington, 98512, United States

    OLYMPIA, WA 985028654

    Phone: (360) 754-5858

    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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00142Anesthesia for lens surgery4342$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope2020$0
00812Anesthesia for exam of colon using an endoscope1414$0
00811Anesthesia for other procedure on large bowel using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 33323)

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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: 3971898644View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
-MI
-MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
-TX

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1265764567.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Certified Registered Nurse Anesthetist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Sunrise, 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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