Unknown Individual – Sports Medicine (Family Medicine) Physician, NPI 1376529297

Unknown Individual is a healthcare provider. based in Orlando, Florida. specializing in Sports Medicine (Family Medicine) Physician. They hold a License No. ME41940 (FL). The NPI Number for Unknown Individual is 1376529297

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1376529297
Phone
(407) 649-6878
Address
1222 S ORANGE AVE
Deactivation Date
28 June 2023

Doctor Profile

Medical School Name
TULANE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4076501300
Graduation Year
1980 (46 years ago)
PAC ID
5799857819
Group Practice PAC ID
9537059084
Professional Enrollment ID
I20100104000658
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

  • Orlando Health Heart Institute, 1222, South Orange Avenue, Orlando, Orange County, Florida, 32806, United States

    ORLANDO, FL 328061215

    Phone: (407) 649-6878

    Fax: (321) 843-2172

    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
99214Established patient office or other outpatient visit, 30-39 minutes4832$0
20610Aspiration and/or injection of fluid from large joint2713$0
View full utilization report →

Insurance plans in this area (ZIP 32806)

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Provider's Procedures

Unknown Individual performs procedures in Sports Medicine (Family Medicine) Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
SPORTS MEDICINEFL20610Aspiration and/or injection of large joint or joint capsule16057

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: 9537059084View full group profile
NameSpecialtyState
Internal MedicineFL
O B S T E T R I C S/ G Y N E C O L O G YNY
Nurse PractitionerFL
Internal MedicineFL
Vascular Surgery, General SurgeryFL
Physical Therapist In Private PracticeFL
Sports MedicineOH
Nurse PractitionerFL
Internal MedicineFL
Internal MedicineIA

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1376529297 for Unknown Individual, then check state licensing separately.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Sports Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Orlando, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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