Unknown Individual – Pulmonary Disease Physician, NPI 1497781793
Pulmonary Disease Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,454 CRITICAL CARE (INTENSIVISTS) in FL
Provider Addresses for Unknown Individual
1921 WALDEMERE ST STE 705
SARASOTA, FL 342392913
Phone: (941) 366-5864
Fax: (941) 365-4276
Type: Location
200 Healthcare Way Unit 102
North Venice, FL 342753670
Phone: (941) 366-5864
Type: Location
2600 Laurel Rd E
North Venice, FL 342753226
Phone: (941) 917-9000
Type: Location
1700 S Tamiami Trl
Sarasota, FL 342393555
Phone: (941) 917-9000
Type: Location
1921, Waldemere Street, Sarasota Heights, Sarasota, Sarasota County, Florida, 34239, United States
STE. 705
SARASOTA, FL 342392943
Phone: (941) 366-5864
Fax: (941) 365-4276
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 175 Open Payments records for all available years, with a total value of $3,306.
Total Amount is formed as General ($3,306) + Research ($0) + Ownership ($0) = $3,306.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($823).
Total Amount
$3,306
General + Research + Ownership
Payments
175
Total payment records
General Amount
$3,306
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-02-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100224000333 | I | Pulmonary Disease | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 793 | 405 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 465 | 383 | $0 |
| 94060 | Test to measure expiratory airflow and volume changes before and after medication administration | 341 | 335 | $0 |
| 94729 | Test to examine how well the lungs exchange gases | 338 | 324 | $0 |
| 94618 | Test for exercise-induced lung stress | 216 | 216 | $0 |
Insurance plans in this area (ZIP 34239)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PULMONARY DISEASE | FL | 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 23 | 22 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Critical Care (Intensivists) | FL | |
| N E U R O L O G Y | FL | |
| Neurology, Neuropsychiatry | SC | |
| General Surgery | FL | |
| - | FL | |
| Physician Assistant | FL | |
| Gynecological Oncology | FL | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Certified Registered Nurse Anesthetist (Crna) | FL |
Reviews
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