Unknown Individual – Internal Medicine Physician, NPI 1417160086

Unknown Individual is a healthcare provider. based in Cape coral, Florida. specializing in Internal Medicine Physician. They hold a License No. ME92469 (FL). The NPI Number for Unknown Individual is 1417160086

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1417160086
Phone
(239) 549-2772
Address
523 CAPE CORAL PKWY E
Deactivation Date
23 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2395492772
Graduation Year
1984 (42 years ago)
PAC ID
4789633272
Group Practice PAC ID
2860388345
Professional Enrollment ID
I20110713000265
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

  • Cape Coral Parkway E, Cape Coral, Lee County, Florida, 33904, United States

    CAPE CORAL, FL 339048545

    Phone: (239) 549-2772

    Fax: (239) 549-2332

    Type: Location

  • 523, Cape Coral Parkway East, Cape Coral, Lee County, Florida, 33904, United States

    CAPE CORAL, FL 339048545

    Phone: (239) 549-2772

    Fax: (239) 549-2332

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 22 Open Payments records for all available years, with a total value of $1,343.

Total Amount is formed as General ($1,343) + Research ($0) + Ownership ($0) = $1,343.

Last reported payment date: 2024-06-26 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($571).

Total Amount

$1,343

General + Research + Ownership

Payments

22

Total payment records

General Amount

$1,343

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-26

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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 minutes40471$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit3535$0
99204New patient office or other outpatient visit, 45-59 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 33904)

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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: 2860388345View full group profile
NameSpecialtyState
Internal Medicine, Cardiovascular Disease (Cardiology)FL
-FL
General PracticeKY

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1417160086 in the public NPI dataset.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Cape Coral, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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