Unknown Individual – Psychiatry Physician, NPI 1285667121

Unknown Individual is a healthcare provider. based in Temple terrace, Florida. specializing in Psychiatry Physician. They hold a License No. OS0007230 (FL). The NPI Number for Unknown Individual is 1285667121

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1285667121
Phone
(813) 513-3095
Address
10929 N 56TH ST
Deactivation Date
15 June 2022

Doctor Profile

Medical School Name
OHIO UNIVERSITY, COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
-
Graduation Year
1988 (38 years ago)
PAC ID
6305896135
Professional Enrollment ID
I20050128000428
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

  • 10929, North 56th Street, Temple Terrace, Hillsborough County, Florida, 33617, United States

    TEMPLE TERRACE, FL 336173000

    Phone: (813) 513-3095

    Fax: (813) 513-3097

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33617)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1285667121.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Psychiatry Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Temple Terrace, Florida because that is what the record indicates for Unknown Individual.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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